formulaire de la mascarade - Otakuthon
formulaire de la mascarade - Otakuthon
formulaire de la mascarade - Otakuthon
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Entré e reçue/Entry received________<br />
No d’entré e/Entry number________<br />
<strong>Otakuthon</strong> 2006<br />
Inscription à <strong>la</strong> Mascara<strong>de</strong>/Masquera<strong>de</strong> Registration<br />
S.V.P. É crire <strong>de</strong> façon lisible/ Please write legibly<br />
Type d’entrée/Type of entry:<br />
___Para<strong>de</strong>/Walk-on<br />
___Sketch/Skit<br />
Division/Division:<br />
___Junior/Junior:<br />
___Novice/Novice<br />
___Intermédiaire/Journeyman<br />
___Artisan/Artisan<br />
___Maître/Master<br />
___Fait par le participant/self-ma<strong>de</strong><br />
___Fait par un adulte/adult-ma<strong>de</strong><br />
___Hors-compétition/Out-of-Competition<br />
Nom(s) du/<strong>de</strong>s participants(s) : _________________________<br />
Name(s) of contestant(s)<br />
_________________________<br />
_________________________<br />
_________________________<br />
Nombre <strong>de</strong> participant(s):<br />
Number of participant(s)<br />
_________________________<br />
Titre <strong>de</strong> l’entrée: ___________________________________<br />
Title of entry<br />
Nom <strong>de</strong> <strong>la</strong> Source (Animé, Jeux, etc) :____________________<br />
Source Name (Anime, Games, etc) ____________________<br />
Costumier (si différent <strong>de</strong>s participants) : ________________<br />
Costumer (if different than contestants) ________________
Entré e reçue/Entry received________<br />
No d’entré e/Entry number________<br />
Texte <strong>de</strong> présentation (max 100 mots) :<br />
Presentation by MC (max 100 words)<br />
_________________________________________________<br />
_________________________________________________<br />
_________________________________________________<br />
_________________________________________________<br />
_________________________________________________<br />
_________________________________________________<br />
Support audio: __oui/yes __non/no Track/piste no ______<br />
Audio support Cue :____________________________<br />
Ne pas écrire/Don’t write<br />
Remarques pour l’équipe technique - Anything for Stage Ninjas<br />
_________________________________________________<br />
_________________________________________________<br />
_________________________________________________<br />
*Nous, sous-signé s, avons lu les règlements <strong>de</strong> <strong>la</strong> Mascara<strong>de</strong> et acceptons <strong>de</strong> s’y conformer. Nous<br />
acceptons aussi <strong>la</strong> publication et <strong>la</strong> vente <strong>de</strong> photos et vidé os prises durant <strong>la</strong> Mascara<strong>de</strong> par l’Organisation<br />
d’<strong>Otakuthon</strong> à<strong>de</strong>s fins <strong>de</strong> non-commerciales. Nous acceptons <strong>de</strong> ne pas tenir l’Organisation d’<strong>Otakuthon</strong>,<br />
ses subordonné s ainsi que l’Université Concordia responsables en cas d’acci<strong>de</strong>nt et/ou <strong>de</strong> blessures. Si le<br />
participant a moins <strong>de</strong> 18 ans, un tuteur lé gal doit signer.<br />
Si vous pensez être absent à<strong>la</strong> cé ré monie <strong>de</strong> remise <strong>de</strong>s prix, s.v.p fournir votre adresse et numé ro <strong>de</strong><br />
té lé phone àl’endos du <strong>formu<strong>la</strong>ire</strong> afin que nous puissions vous envoyez votre prix dans l’éventualité que<br />
vous gagneriez.<br />
* I/We the entrant(s) have read and un<strong>de</strong>rstood the rules of this Masquera<strong>de</strong> and agree to abi<strong>de</strong> by them.<br />
I/We also agree to allow for the photographing and vi<strong>de</strong>otaping of this event and to permit the sale of said<br />
photographs and vi<strong>de</strong>otapes by the <strong>Otakuthon</strong> Organization for non-commercial purposes. Further, I/we<br />
agree to hold the <strong>Otakuthon</strong> Organization, its subordinate and Concordia’s University b<strong>la</strong>meless for any<br />
acci<strong>de</strong>nts or injuries suffered during the Masquera<strong>de</strong>. If entrant is un<strong>de</strong>r 18 years of age, parent/guardian<br />
must sign.<br />
If you are not going to be attending the award ceremonies, please provi<strong>de</strong> contact information (mailing<br />
address, phone number) on the back so we may send you any awards that you may win.<br />
Signatures <strong>de</strong>s participants* - Contestant’s signatures* :<br />
_________________________________________________<br />
_________________________________________________<br />
_________________________________________________<br />
_________________________________________________<br />
_________________________________________________
Entré e reçue/Entry received________<br />
No d’entré e/Entry number________<br />
Adresse postale:<br />
Mailing Address :<br />
Nom :_________________________________<br />
Name<br />
Adresse:__________ Rue :___________________ App :____<br />
Address : Street : App :<br />
Ville:____________________________ Province:__________<br />
City:<br />
Province:<br />
Co<strong>de</strong> postal :_____________<br />
Postal co<strong>de</strong> :<br />
Numéro <strong>de</strong> Téléphone :_____________________<br />
Phone number :
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