Warner Theatre - Information: Rent/Production

APPLICATION TO RENT

Name of Presenter:_______________________________________________________

Contact:________________________________________________________________

Address:________________________________________________________________

Website:________________________________________________________________

Telephone: OFFICE (___) _________________ RESIDENCE (___) ___________________

Fax: (___) _________________ E-mail:________________________________________

Date(s) Requested:_____________________ Alternate Dates:____________________

Presenter is:
____Corporation
____Individual
____Partnership
____Other, please describe with attachment.

Federal Identification No.: ___________________, or
Social Security Number (if individual) : ______-_____-______

In which state corporation/partnership incorporated/registered?_______________

Names of Officers/Partners:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Name and title of authorized person signing contract:
______________________________________________________________________________
______________________________________________________________________________

Please list below three venues where Presenter has presented events within the past 18 months.

VENUE (WITH CITY/STATE) DATE TELEPHONE NUMBER

__________________________ _________________________________ (____) _______________

Please attach program from the above events. Clear and legible photocopies are acceptable.

Please give below the name, address and telephone of the insurance firm that will provide Worker's Compensation and Employer's Liability (including Disability Benefits ), Comprehensive General Liability (Personal Injury, including bodily injury, $1,000,000 per occurrence; and Property Damage, $100,000 per occurrence), Theft and Fire insurance, and Landlord and Tenant public liability policy:

Broker'sName:__________________________________________________________________
Address:_______________________________________________________________________
Telephone: (___) _____________________________________

Please give a short description of your proposed event.

______________________________________________________________________________

Length of event:_______________________

Please list below the names of principal participants/artists/performers/speakers in your program.

________________________________ ____________________________________

Name, address & telephone number of artist's agent and agency:

_______________________________________________________________________________

For each artist above, please attach a list of three public venues where he/she has appeared with the past six months. (Please attach additional pages if necessary.)

VENUE (WITH CITY/STATE) DATE TELEPHONE NUMBER

_________________________ ________________________________ (____) _________________________

If possible, please attach a technical rider outlining clearly technical requirements. This must include sound, light and set-up information.

Anticipated number of hours for load-in:___ Anticipated number of hours for load-out:___

Are you planning on hosting a pre- or post-event reception? ___Yes ___No

This event will be:

____For public sale

____By invitation only

____Free (tickets required)

____Other (please attach details)

I understand that all ticket monies (for publically-promoted event) are deposited with the Warner Theatre ; consignment tickets are paid to the Warner Theatre before tickets are released. ___ Yes

Are any dignitaries, VIPs, head of states, etc. anticipated to attend event? ___Yes ___No

If yes, list names:__________________________________________________________
_______________________________________________________________________

Please give the name of Presenter's current bank, address, telephone number:

_______________________________________________________________________

Please give the name, title, and telephone number of an official at this bank as a reference:

____________________________________ (____) _____________________________

It is hereby agreed to by the person/organization (Presenter) requesting the use of this theatre that no information or publicity of any nature relating to the proposed event may be announced or released in any manner until the standard license contract is executed by the Warner Theatre Operating Group and Presenter and the required deposit has been paid.

Furthermore, Presenter hereby represents that a full, accurate and complete disclosure of all information has been made and that the above statements and information are true and correct. Presenter hereby gives permission to the Warner Theatre Operating Group to contact any of the above-named entities as personal and/or business references.

By:_____________________________________________________________________

Name:______________________________ Title:________________________________

Date:_______________________________

Please attach any additional information pertinent to your presentation including audio/visual recordings, photographs, etc.

Please return this request and all supporting material to:

The Warner Theatre
Programming Department
1299 Pennsylvania Ave., N.W., Suite 111
Washington , D.C. 20004-2405
(202) 783-0204 (fax)