Belfry Theatre Rental Request Form

Company

Production or Event Name

Primary Contact*

Primary Contact Phone Number*

Primary Contact Email*

Secondary Contact

Secondary Contact Phone Number

Secondary Contact Email

Mailing Address*

Street Address City Province Postal Code

Website

GST/ Business Number

Society/ Charitable Resigtration Number (Non-Profit Rate)

Requested Space(s)

Stewart Mainstage
BMO Studio Theatre
Studio B
Lobby

Requested Dates

Alternate Dates

My dates are flexible

Performance/ Event Start Time

: HH

MM

Approximate Length of Performance/ Event

Is there an intermission / interval?

Yes
No
Multiple Intervals

Number of Artists/ Participants in the production/ event (not including audience):

This gives us a sense of your backstage and dressing room needs.

Brief Description of the Event (75-100 Words)*

Ticket Price

Select one:

Ticket price plus GST
Ticket price includes GST

Ticket Face Wording (printed tickets):

10-12 Words MAX, that will appear on all printed tickets (ie - The Belfry Theatre presents God of Carnage by Yasmina Reza)

Complimentary Tickets (number to hold back from sale)

Desired date to start ticket sales:

Type of Event (select all that apply)

Rehearsal
Theatrical Production
Reception
Lecture
Concert
Dance Production
Meeting
Private Party
Other

How do you want to use the dates requested?

(ie - 1 day rehearsal, 1 day tech, 3 days performances (2 performances per day))

Do you need Lighting:

Yes
No

Please give a brief detail of your Lighting needs:*

Do you need Sound?

Yes
No

Please give a brief detail of your Sound needs:*

Do you need A/V?

Yes
No

Please give a brief detail of your A/V needs:*

Is the event open to the Public?

Yes
No

Do you want to hold a pre or post show reception? (check all that apply)

Pre-show
Post Show

Do you want to set anything up in the Lobby? Please elaborate:

ie - Posters, banners, promo materials, merchandise, silent auction, raffle, decorations, etc.

Anything else we should know?

250-385-6815 boxoffice@belfry.bc.ca

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