Group/Individual Name: ______________________________________________________
Type of Entertainment: ____________________________________________________________
Mailing Address: _____________________________________________________________
City/State/Zip: ____________________________ Business Phone: ____________________
Contact Name: ___________________________ Cell Number: _______________________
Email Address: ___________________________ Website Address: _____________________
Name as it should appear in program/schedule: Click here to enter text.
Description of entertainment: Click here to enter text.
Length of performance (15 or 30 minutes): Click here to enter text.
Age restrictions (if any):Click here to enter text.
Specific equipment required (note: entertainers should plan to supply sound system and speaker system unless otherwise
coordinated in advance of the event): Click here to enter text.
Other setup or venue requirements: Click here to enter text.
Are you willing to repeat the performance? YES NO
Times available (August 17 and/or 18): Click here to enter text.
NO SALES ARE ALLOWED unless coordinated in advance of performance.
By signature entertainer agrees to be bound by the terms and conditions set forth by the enclosed guidelines.
Presenter Signature: __________________________ Today's Date: ________________
Geekfest Approval: __________________________ Date: _____________
Submit completed form to:
Geekfest 2014, clo Jennifer Hetzel or Barbara Merlo,