Twin Lakes Playhouse
P.O. Box 482
Mountain Home, AR 72654
Application for Annual Membership

Name: Today's Date:
Address: City, ST, Zip:
Email: Age:
Home Phone: (     ) Work Phone: (     )
Newcomer to the area? If so, where from?

Membership dues are $5.00 per year for members over 16 years of age. You must be a Playhouse member to be involved in any way with a play and sign the Release and Authorization statement. We urge you to attend regular monthly membership meetings, which are held on the third Monday of each month at 7:00 p.m. at the Playhouse in Mountain Home. The Membership Chairman has a copy of the by-laws and standing rules of the Playhouse.

RELEASE AND AUTHORIZATION 

I,  __________________________________________, hereby authorize the Twin Lakes Playhouse to release any photographs and/or theatrical background information concerning me regarding any legitimate production in which I may be involved in for the Twin Lakes Playhouse for advertising and publicity purposes only, concerning the production in which I may be involved in, including but not limited to: playbills, newspapers, magazines or over the Internet. I further hold harmless Twin Lakes Playhouse from any liability or damages, which may result from such publication. 

___________________________________                   _______________________________________
Signature                                                                        Printed Name

Playhouse Activities: Please indicate your interest

Stage

  

Acting

  

Design/Build Sets
   

Directing

  

Artwork/Paint Sets
   

Costumes

  

Stage Manager
   

Props

  

Make-up/Hairstyling
   

Sound/Lights

    
         

In House

  

Concessions

  

Tickets/Ushering
   

Parking

 

Ticket Sales
         

Marketing

  

Newspaper

  

Playbills/Posters
   

Radio Spots

  

Photography
         

Support

  

Play Reading

   

****Please print form, complete, and mail form and check to address listed above****