CUM AS YOUR MADNESS

I am 18 or older Yes No

I have read the disclaimer regarding physical and mental restrictions and confirm that non of this applies to me Yes No

I have no history of physical or sexual violence (both victim or perpetrator) Yes No

I can provide proof of a clean criminal record Yes No

I am able to invest the time and energy required Yes No

I don't back out of engagements Yes No

I am a compassionate person 0 (absolutely not) 1 2 3 4 5 6 7 8 9 10 (extremely compassionate)

I feel confident sharing ideas in a group setting Yes No

I feel confident expressing a different opinion than others Yes No

I am ok with signing a non-disclosure contract and that everything that happens or is discussed while working on the project, AND during the run of the performance can not be communicated in any way! A haunted house experience like this loses all its impact when people know what to expect. Yes No

I deal well with criticism Yes No

I am able to improvise Yes No

I am not trans- and homophobic Yes No

I am not a racist Yes No

I am comfortable with depictions of sexual activity Yes No Only on screen Not sure

I am comfortable with depictions of violence Yes No Only on screen Not sure

I am comfortable with depictions of torture Yes No Only on screen Not sure

I am comfortable around nudity Yes No From a distance

I am comfortable being nude or partially clothed Nude Partially clothed No

I am comfortable enacting SIMULATED violence Yes No Not sure

I am comfortable touching people Yes No

I am comfortable touching people Yes Y No N I am comfortable touching people in a hands on, agressive manner Yes No

I am comfortable touching people in a suggestive manner Yes No

I am ok with (fake) bodily fluids Yes No Blood Puke Urine Feces Sperm

I am ok with my feet, hands,... touching various unusual textures Yes No

I can handle foul smells Yes No

I am not easily intimidated 1 (very easily) 2 3 4 5 6 7 8 9 10 (never)

I can easily differentiate reality from pretend Yes No

I am able to deescalate aggressive situations Yes No

I can handle uncomfortable temperatures Yes No

I know how to perform basic first aid or CPR (cardiopulmonary resuscitation) Yes No First aid only CPR only

I am aware that I will always be in a safe environment and that there will be constant conversation and communication to make sure that all people involved are engaging in situations that are well inside their boundaries of comfortability Yes No

Please provide a very short motivation on why you would like to participate. You are also encouraged to write down any specific talents you think could be interesting to incorporate (music, acrobacy, specific languages you speak, technical experiences, costuming, etc)*

Marijke De Roover
CUM AS YOUR MADNESS

APPLICATION FORM

share!

Marijke De Roover CUM AS YOUR MADNESS

APPLICATION FORM

share!

Marijke De Roover
CUM AS YOUR MADNESS