Open Mic Night: Application Form

PERFORMER APPLICATION

_______________________________

This form is to be used To schedule you or your band to perform during our open mic night or any other Special Events.

_________________________________________

!!Important Notice!!

By Filling Out this form you Agree and Understand to the Following.
If you have any questions fill out the form anyways and put them in the comment section.

This is Not a Paid Performance
Management/DJ Reserves the Right to Terminate any performer if there are excessive complaints
Unlimited Go-Kart and Arcade is Offered to Each Band Member + 1 Guest
There may be times when the date you request is not available, Particularly during Special Events.
You agree to Have a Good Time and Show the Customers what you do best!
_________________________________________

All information is required.

Processing of applications normally takes 1-2 DAYS
You will be notified immediately upon completion of processing.

Today's date is: (select below)

Please provide the following information about yourself:

Group Name:

First Name:

Middle Name:

Last Name:

Title or Position:

E-mail Address:

(Your e-mail address assigned to you by your ISP)

Alternate Email:

Please note: no Unverifiable addresses such as, free accounts, hotmail, yahoo, etc.

Postal Address:

City:

State / Province:

Postal Code: (Zip)

Telephone Number: - -

Alternate Number: - -

Have you or your band ever performed at Speed Park Before?

If so, When

How Many Members are in your Group?

What type of Music do you Play?

How Many Hours of Music can you Play?

What Time would you like to Perform?

What date would you like to Perform?

Do you have any Needs?

Do you have any questions, comments or concerns?

All information is held in complete confidence and will not be released for any reason.

Please click on the SUBMIT button, when you have completed this application.

Only click the submit button once, please.

Thank you!

Please Enter the Code (Copy and Paste Will Work) that is Red in the Box to the Right PDJSPOMN

All information submitted on this form is held in strict confidence
and will not be released under any circumstance.

Notice: All page accesses and activities on this Web Site are monitored and recorded.

Group Name:
First Name:
Middle Name:
Last Name:
Title or Position:
E-mail Address:	(Your e-mail address assigned to you by your ISP)
Alternate Email:	Please note: no Unverifiable addresses such as, free accounts, hotmail, yahoo, etc.
Postal Address:
City:
State / Province:
Postal Code: (Zip)
Telephone Number:		-	-
Alternate Number:		-	-