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Name:     

Street Address:
    

City:       State:       Zip:  

Phone Number:     

E-Mail Address:   

Age:       Gender:      

Select your game date:
 Columbia

Be a:
Check all that apply
 Dashing Hero     Vile Villain     Damsel in Distress

Enjoy:
Check all that apply
 Intrigue       Romance       Mystery
 Politics       Trouble       Secrets
 Mayhem       Espionage       Mysticism
 High Weirdness       Freaks

I would be willing to:
Check all that apply
P Be cast cross gender, even into a romance plot.
P Perform in front of an audience.
P Entertain small children as they wander about game space.
P Wear clown makeup for the duration of the game.
P Wear evil clown makeup for the duration of the game.
P Wear a temporary tattoo for the duration of the game.
P Have all of my visible body parts covered in temporary tattoos for the duration of the game.
P Wear a fake beard or fake hair for the duration of the game.
P Wear a domino mask for the duration of the game.
P Be physically attached to another player for the duration of the game.
P Play a character with a speech impediment (mute, stutters, must speak in rhyme, etc).
P  Play a character who is destined to fail.

I am able to:
Check all that apply
P Juggle.
P I'd be willing to learn how to: Juggle.
P Juggle Fire.
P I'd be willing to learn how to: Juggle Fire.

Any other comments?