Adams Memorial Opera House
 Rental Application

Instructions:

Please answer all of the applicable questions on this form. Your answers will be used to prepare your Rental Agreement, and to schedule the necessary facilities. You should read the Opera House Rental Checklist before you complete this form. If the dates you request are unavailable, or there are any questions or potential problems, we will contact your Responsible Contact Person.  Some of this information is requested for use on our Box Office telephone hotline and our online Schedule of Events. This helps to publicize your event.  Mandatory information, for form submission, is indicated by bold typeface.  When completed, hit the Submit button at the bottom of the form.

Organization Information:

Name of your Organization: 

Your Organization's postal mailing address:  

Your Organization's Internet E-Mail address (if any): 

Your Organization's Internet Web Site URL (if any): 

Name of your Responsible Contact Person : 

Contact Person's telephone:    (Day)    (Evening)

Event Information:

Title of your production or event:   

Please describe your production or event (unless it's obvious from the title).

What dates and times do you request for the performance or event?  (Exclusive of any setup, teardown or rehearsal, which are addressed below.)
 

What are the actual event starting times (curtain time)?

What are your admission prices and discounts (if any)?

Do you have a phone number for more information about your event?

What dates and times do you request for rehearsals? (Or enter 'none'.)

What dates and times do you request for 'tech' setup and teardown? (Or enter 'none'.)

Facility Usage Information:

Please select the spaces you wish to rent:     

If you selected all spaces, do you need the Green Room and Dressing Rooms for all
rehearsals and performances (as requested above)?     Yes    No

        If no, for what dates and times will you need these additional spaces?
       

Are you requesting some extra Green Room Only (rehearsal) dates in the above listing?  (Yes)

Do you request a non-standard Opera House seating arrangement? (Yes)

If yes, please explain. 

Do you wish to consult with us regarding your potential technical requirements?  (Yes)

Do you plan to use special effects, strobe, smoke, fog, pyrotechnics or open flame? Yes  No

Please describe the technical requirements of your production or event. (Or enter 'none'.)

Unless you entered 'none' above, please enter the names of the following staff positions for your production, from our list of Certified Production Staff.  If you are unable to obtain the services of qualified production staff, please contact us.  We may be able to assist.
House Manager:                Stage Technician:            
Lighting Technician:           Sound Technician:       

Additional Renter Requirements:

Does your group have the required $1,000,000 general liability insurance coverage?   Yes No

If not, do you have a lesser coverage amount?  $

Do you have a crew of volunteers to clean up the Opera House after each use?   Yes  No

You have the option to purchase post-event cleaning services from our professional cleaning contractor, for an additional $250.00 fee.  This service must be scheduled significantly in advance of your load-out.

Would you like to purchase optional post-event cleaning services?  Yes    No

        If you are not providing a cleaning crew or purchasing the optional cleaning services, please explain how the required cleaning will be accomplished (e.g. hired contractor):
       

Are you requesting permission for consumption of beer or wine at your event?  (Yes)

Do you anticipate the need for Police Detail coverage?  (Yes)   Fire Detail coverage?  (Yes)

Any additional comments about your event not otherwise covered in this application form?

Have you read the Opera House Technical Package Yes No

Have you read the Opera House Rental Checklist?    Yes No

Have you read the Opera House Cleaning Checklist?    Yes No

        

Instructions: Hit the Submit button to transmit the completed form to the Greater Derry Arts Council, Inc.  Rental questions may be directed to our office staff at 603-437-0505.  Technical questions may be directed to Dave Nelson, Technical Director, at 603-432-2796. We will send you a formal Lease Agreement to sign and return to us.

Form updated as of: Saturday, May 03, 2008