Theatre Rental
Request Form
To be completed by applicant:External clients must submit this formFIVE WEEKS prior to performance date. Form must be APPROVED prior to performance date to fulfill contract stipulations.
Legal Organization Name: ______
Stage Manager/ Production ManagerContact Name:______
Name of Event: ______Date of Event: ______
Artist or Organization Website:______
Applicant is:Individual Corporation Commercial Promoter
501 C3 (nonprofit)Local Arts
PERFORMANCE DETAILS
Date of Performance:______Type of Performance:______
Title of Performance:______
Total Number of Performers:______
Short Description of Performance:______
______
______
Performance Start Time:______Run Time:______Intermission: Yes No
Load-In Date:______Time: ______
Sound Check/Rehearsal Date: ______Time: ______
Load Out Date: ______Time: ______
Estimated Attendance #:______Admission Charge: Yes If yes, Price: ______. No
Anticipated ON SALE date: ______
TECHNICAL REQUIREMENTS
Do you have a TECHNICAL RIDER for your Performance/Event? Yes No If yes, please provide.
Do you have Stage Manager? Yes No If yes, please provide.
Name: ______
Phone: ______Email: ______
STAGEYESNOSTAGE NOTES
Podium______
Tables (side stage or on)______
Chairs______
Music Stands______
Piano______
Piano Tuning______
Marley Dance Floor______
Risers______
Flags (hung or standing)______
Banner Display______
SOUNDYESNOSOUND NOTES
Handheld Microphones______
Wireless Microphones______
CD Player______
IPOD______
Computer______
Other______
______
LIGHTINGYESNOLIGHTING NOTES
Follow Spot______
______
A/VYESNOA/V NOTES
Projection______
Screen______
Videotaping/Media______
* For Archival purposes renter must submit a letter stating that material will not be used for commercial use.
MISCELLANEOUSYESNOMISC. NOTES
Dressing Rooms______
Backstage Food Service______
ADDITIONAL PRODUCTION NOTES
______
ADDITIONAL ACTIVITESYESNODETAILS (LOCATION,TIMES, CREATED BY, ETC.)
Merchandising/Souvenir Sales______
Will you sell or we need to provide a seller?______
Program Distribution______
Will you have any stuffers to be inserted in the program?______
Registration or Media Tables______
Poster/Banner Display (lobby)______
Pre or Post Show Reception______
REFERENCES:
Below, please provide the information on local venues that you have leased within the last 24 months for the purpose of presenting similar events. If you have no local history, please provide information on similar venues in other cities.
Venue 1:______City: ______State: ______
Capacity: ______% Sold: ______Dated Booked: ______
Contact Name: ______
Contact Title: ______Phone: ______
Contact Email: ______
Venue 2:______City: ______State: ______
Capacity: ______% Sold: ______Dated Booked: ______
Contact Name: ______
Contact Title: ______Phone: ______
Contact Email: ______
Venue 3:______City: ______State: ______
Capacity: ______% Sold: ______Dated Booked: ______
Contact Name: ______
Contact Title: ______Phone: ______
Contact Email: ______
* By filling out the above information you give Karamu House all rights to contact the above venues for the sole purpose of inquiry about renter’s previous events.
Office Use Only
Scheduler name: ______Date: ______
AcceptedAccepted with RevisionsNot Approved
SchedulerNotes:
______
Revised 4.5.17Theatre Rental page1