WISE FOOL NEW MEXICO
1131-B Siler Rd, Santa Fe, NM 87507
505-992-2588 // www.wisefoolnewmexico.org
ELEVATE Adult Circus Intensive
Info & Registration Form 2016
Elevate Circus Intensive Workshop provides a safe space for women and men of all shapes, sizes,
ages (16-90+), gender presentations, backgrounds, and ability levels to come together and explore their
physical and inner strength while building trust and community. Participants learn stiltwalking, trapeze,
aerial fabric, acrobatics, conditioning, clown, and object manipulation. No previous circus experience of
any kind is required!! The intensive culminates in a showcase performance for friends and family of the
participants!
SCHEDULE:
ELEVATE 2016 will take place January 4th thru 16th.
Skills Classes will be held from 6 to 9pm on Mondays, Wednesday and Fridays
PLUS Saturday Jan 9th from 12noon to 4pm
Conditioning classes will be held from 8 to 9am on Tuesday and Thursdays
PLUS 7:30 to 8:30pm on Tuesdays
Showcase Performance will be held on Saturday January 16th at 4pm.
All classes take place at the Wise Fool Studio in the Agua Fria Business Park near the corner of Siler
Road and Agua Fria. The address is 1131-B Siler Rd, Santa Fe, NM 87507.
Workshop Fee for the two-week program is $350 – there is an early bird deal of $300 for
registrations/deposits received prior to December 21, 2015. Partial Scholarships and Work Trade are
available. This tuition covers circus instruction and planning by professional circus artists and teachers
and a priceless experience in self-discovery, strength building, and community!
A $150 deposit is due upon receipt of this registration in order to reserve your spot. The remaining
balance is due on or before the first day of class. If your balance is not paid by the due date, we will
add a $25 late payment fee. You may request a payment plan if needed, but you must do so before
classes begin. Cancellations after December 28 will not receive a refund of the deposit. Cancellations
after the first day of class will not receive any refund of the deposit or workshop fee.
*Partial Scholarships and Work Trade are available, To apply, request a scholarship application. We will
determine scholarships by December 28, 2015.
For more information or questions about the ELEVATE program, please contact ELEVATE 2016
Program Director Deirdre Morris at 505-670-2659 or email deter1234@yahoo.com.
Please keep this page for your records
ELEVATE Registration Form 2016
Please fill out completely and return with $150 deposit to:
Wise Fool New Mexico, 1131-B Siler Rd, Santa Fe, NM 87507
Name:
Age:
Address:
Phone Day:
Email:
Eve:
Mobile:
Please indicate any personal preferences or needs (i.e. Nicknames, preferred pronoun, etc.):
Please list any medical injuries, allergies, physical limitations and current medications:
Emergency Contact (Name & Phone)
Primary Care Physician:
Insurance:
Medical treatment requests:
Wise Fool is required to capture “ethnicity” information for government grant funders of the
ELEVATE program using the following “categories.” Please select the box with which you
most self-identify. Your response is confidential and will in no way impact your entrance.
Native/Indian
Hispanic/Chicano
Caucasian/Anglo
Black/African American
Asian/Pacific Islander
Other (please specify)
Please self-identify if you wish.
Lesbian/Gay
Queer
Straight
Bi
Genderqueer
Other (please specify)
How did you hear about the workshops?
Word of mouth
Flyer
Wise Fool website
Wise Fool email
Facebook
Other(please specify):
Have you ever participated in a Wise Fool Workshop before? If so,
what was your experience?
Have you had previous circus or theatrical experience? If so, please explain:
What do you hope to gain from these workshops?
Please give us a brief description of any prior experience you have in each of the following
circus arts (include an overview of skills or skill level you can do at this time–not just in the
past—safely, and without a spotter):
Trapeze, Fabric, Stilts, Partner Acrobatics or Acro Yoga, Juggling /Manipulation,
Clown/Physical Theatre
WAIVER
I am aware that Wise Fool is here to serve me by sharing knowledge of circus arts. I understand that
these practices involve physical movement that may from time to time be strenuous and that such
practice carries some risk of injury. I also understand that I must judge my own capabilities in regard
to classes. I agree to take full responsibility for not exceeding the limits of my body. I acknowledge
that it is my responsibility when I begin a class to inform the instructor of any injury or other
condition that might affect my ability to participate, and to inform the instructor immediately if any
injury should occur during the workshop.
I HEREBY WAIVE AND RELEASE ANY CLAIM THAT I MIGHT HAVE AT ANY TIME FOR INJURY
OF ANY SORT AGAINST Wise Fool New Mexico OR ANY PERSON OR ENTITY IN ANY WAY
INVOLVED THEREWITH, INCLUD- ING WITHOUT LIMITATIONS ITS PRINCIPALS,
INSTRUCTORS, EMPLOYEES, AGENTS, REPRESENTATIVES, BOARD MEMBERS, GUEST
ARTISTS, PERFORMERS, EQUIPMENT MANUFACTURERS, AND WORKSHOP LEADERS.
I HAVE CAREFULLY READ THE RELEASE, FULLY AND UNDERSTAND AND AGREE TO THE
ABOVE.
SIGNATURE
DATE:
PHOTO/VIDEO RELEASE
Wise Fool would like to document the events at the workshops for future use. By signing below you
authorize Wise Fool to photograph you and use your image for documentation or promotional
purposes.
We hope to generate support for future projects by showing the community and our funders what we
do.
SIGNATURE
DATE
:
Please Fill Out and Print
Form
Return By Mail or By Hand with
deposit to:
1131-B Siler Rd, Santa Fe, NM 87507