Select the licensing fee based on your total adult attendance (you may choose $200, $300, or $500 depending on size). If your event exceeds 100 adults, enter custom amount below field.
Enter your custom amount for events with more than 100 adults; calculate the total as $500 plus $5 for each adult over 100. Example: 125 adults = $500 + (25 × $5) = $625 total.
Please sign below to confirm your authorization and agreement to the terms and conditions for licensing the film.
Date Signed