Rental Interest Form

Today's Date *

MM

DD

YYYY

Name *

First Name

Last Name

Phone *

(###)

###

####

What age(s) are your students/participants?

Check all that apply

0-9

10-19

20-29

30-39

40-49

50-59

60-69

70-79

80+

Does rental involve live music? *

Yes

No

Sometimes

Does rental involve recorded music? *

Yes

No

Sometimes

Does rental require quiet conditions? *

Yes

No

Do attendees wear shoes? *

Yes

No

Sometimes

If attendees wear shoes, are shoes soft soled? *

No heels permitted.

Yes

No

Attendees do not wear shoes

If attendees wear shoes, are they worn indoors only? *

No street shoes permitted.

Yes

No

Attendees do not wear shoes

If you intend to use aerial rigging, how will it be used?

Class

Rehearsal

Performance

If you intend to use aerial rigging, can you provide proof of general liability insurance?

Yes

No