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            POST-CONVENING EVALUATION 


PLEASE COMPLETE THE FOLLOWING FORMS:

Due no later than May 1st, 2016.

EMERGENCY CONTACT INFORMATION
PHOTO/VIDEO RELEASE
PHOTO UPLOAD (Optional)
REGISTRATION (If you have filled this out previously in another format, you do not need to complete again)


EMERGENCY CONTACT INFORMATION:

Name *
Name
Emergency Contact Name *
Emergency Contact Name
Emergency Contact Phone *
Emergency Contact Phone
Please include any medical or personal information you would want an emergency medical provider to know.
Company and Policy number

PHOTO/VIDEO RELEASE:

AXIS Dance Company is a non-profit arts organization and therefore we rely on our outreach and media efforts to engage our publics and share our work. From time to time, we require photographs, videos and other images of people involved in our programs, events, workshops and classes. The purpose of these images is to support AXIS Dance Company.

I hereby give AXIS Dance Company and all persons acting under AXIS’ permission the right to use my name, picture, portrait, photograph and video. I waive any right to inspect or approve the photograph(s) or video(s) or any collateral incorporating the photograph(s) or video(s). I agree that the photographer or AXIS Dance Company owns the copyright to these photographs in all cases.

All revenue generated by the distribution of said photograph(s) and/or video (s) will be used for the sole support of outreach, educational programs, and performance expenses of AXIS Dance Company, a non-profit tax-exempt organization.

Name *
Name
By typing your name and clicking "submit," you agree to the terms of the above photo release.
mm/dd/yyyy

PHOTO UPLOAD (OPTIONAL):

You have the option to submit images from you or your organization that pertain to the national convening or the field of physically integrated dance. These images will be included in a slideshow that will run at events throughout the convening. All images must be 1080p, watermarked with your organization's name or logo, and must be in .jpeg or .gif file formats. Images that do not fit the above standards may be excluded. Three images per individual/organization. Due no later than May 1, 2016. For questions, contact Company Administrator Breanna Lee at breanna@axisdance.org.