FORM SUCCESFULLY SUBMITTED!



Event Name:

Event Type:

If other selected describe:

Is activity: Public or Private

If Public is there an entrance fee? No Yes

If yes how much?

Date of Activity:*

Activity Start Time:* hh:mm AM PM

Activity End Time:* hh:mm AM PM

Scheduled Time of Performance:* hh:mm AM PM



Event Location:

Address:*

Building Number

Room number/location:

Spcecial Access required: Yes No

If Yes explain:

Performance Area: Indoor Outdoor

Dance surface & dimension:

Dressing Rooms:* Office Bathroom Other

If Other describe:

Available Sound:* None DJ CD Player Live Music Other

If Other describe:

Music format desired:* MP3CD iPad

Available Parking: Spaces provided at Facility. #provided:

There is Fee for parking at a cost of

Names required for Parking

Parking Restrictions. Describe

On the Street Near by Parking Lot

Special Requests:

Is Photography permited? : Yes No

Contact Info:

Name:

Position:

Phone:

Home: Work: Cell:

Address:

City:

State:

Zip Code:

E-mail Address:

Compensation: Our standard fee is $350 per couple (negotiable) or we accept donations.

Delays, Postponements, etc.
If there is a need to cancel due to weather, and GRUFOLPAWA is present, we are entitled to 50% of the amount agreed upon. We must receive 48 hours notice if the event is to be cancelled. Otherwise, full payment must be made.

By clicking on the above check box and submitting your request to us, you are accepting the above conditions.