Request for Reader Info

We’re excited to have you take our stage soon, but before that happens, we need to gather a little info to help us prepare the show.

We highly recommend you read over the entire form before you begin filling it out to make sure you have everything at the ready to complete it in one fell swoop. If you have a question or concern about anything below, please email us at BeHeard@RocSpoke.org, and we’ll do our best to get back to you quickly.

YOUR DETAILS

Name(Required)

First Last

Email(Required)

Phone(Required)

ABOUT YOU

Your Name as You Want it to Appear in the Program (This is also how we'll announce you to the stage.)(Required)

The Pronunciation of Your Name if You Think We Might Screw it Up (We definitely might.)

Your Preferred Pronouns(Required)

SelectHe/Him/His/HisShe/Her/Her/HersThey/Them/Their/TheirsOther (Enter Below)

Other Pronouns(Required)

Your Bio (3rd-person, 390 characters maximum)(Required)

Your Answer to This Question: What is a memorable moment for you at a Rochester Spoken Word event?(Required)

Tell Us a Fun Fact About You! (We'll use it when we introduce you.)(Required)

Headshot (It doesn't need to be professional, just clear.)(Required)

I want you to use my headshot that you currently have on file from a previous event

I will upload a headshot

Upload Your Headshot(Required)

Accepted file types: jpg, gif, png, jpeg, Max. file size: 256 MB.

Anything Else You Want to Tell Us About You

IMPORTANT STUFF

Consent to Being Recorded(Required)

I consent to having my performance and visage recorded (via audio, video, and still photography), streamed live, and made available for video-on-demand releases. I also consent that such recordings may be used by Rochester Spoken Word to promote itself and its events and may be used as part of future productions.

Notification of Possible Covid-19 Exposure(Required)

I confirm that if in the 5 days leading up to my performance date I have been around another person who has tested positive for COVID-19 or is suspected of having COVID-19 or if I have had a positive COVID-19 test or suspect that I may have COVID-19, I will contact and speak with a member of Rochester Spoken Word before attending the event.

Agreement to Not Attend if Feeling Ill(Required)

I agree that if I am running a fever or otherwise feeling ill on the day of the event, I will contact Rochester Spoken Word to notify them and not participate.

Please Complete the Math Problem to Prove You are a Sentient Being with Basic Math Skills