1.    Name of our theatre group

2.    Location address of our theatre

3.    Name & telephone number of contact person

4.    Name of the lessee [renter]

5.    Address of lessee [renter]

6.    Briefly describe nature of event for which the lessee intends to rent your facility
         

7.    Rental date[s]

8.  Estimated number who will attend                 

9.    Does the lessee have any valid / collectible insurance?   YES     NO
          [By answering NO, you are confirming that the lessee does not have any valid/collectible
           insurance. Should it be determined otherwise, any insurance provided under your
           insurance will be declared null and void and you risk having your own insurance canceled]

10.  Our insurance will not provide any liquor liability coverage. If lessee intends to
           provide, serve, distribute or sell alcoholic beverages, they must provide their
           own liquor liability insurance.

Please press the Submit button only once. It may take a few moments to process