Platinum Performance Dance Academy
148 New York Avenue / 2843 Jerusalem Avenue
Huntington, New York 11743 / Wantagh, New York 11793
631.271.5678 / 516.308.7055

Room Rental Request

Small Room: $30* an hour for use. Includes 15 minutes prior to starting time to allow set up. Class must end promptly on time. Renter may use 15 minutes after the rented time outside of the classroom to pack up. *Proof of nonprofit receives a $5 discount

Big Room: $50* an hour for use. Includes 15 minutes prior to starting time to allow set up. Class must end promptly on time. Renter may use 15 minutes after the rented time outside of the classroom to pack up. *Proof of nonprofit receives a $5 discount

An additional $10 flat rate is added if the studio is being rented on a day and time the studio is not open. This fee is to cover the person who must lock, unlock and clean up during non business hours.

All participants must sign a studio waiver prior to use.

All rental payments must be made in cash or check to cash and paid in full prior to use.

NO STREET SHOES MAY BE WORN IN THE CLASSROOMS

All stereo equipment and lights must be turned off after to use to avoid additional fees.

The use of Platinum Performances classroom equipment is not permitted such as, Matts, bars, trampolines etc…Please make sure your participants abide by these rules or additional fees may be added.

Please provide insurance information if applicable.

MUST SIGN PARTICIPATION WAIVER FORM

Name of Renter: Address:

Email:

Phone: Cell:

What is the space being used for?

______

Date/Time Requested

1.  ______Big Room/Small Room______

2.  ______Big Room/Small Room______

3.  ______Big Room/Small Room______

4.  ______Big Room/Small Room ______

5.  ______Big Room/Small Room______

Number of total hours: / Additional $10 fee / Total Due: / Payment Type:
(Cash or check to cash ONLY) / Date: