"*" indicates required fields I/we agree to present a program entitled:*This program will take place on (list day, date, and time):*The cost of the program will be:*Briefly describe the program:*How long will setup take?*How long will breakdown take?*List any additional requirements (special setup, equipment, etc.):*The program will take place in the following location:* On premises Zoom Facebook Live Other Would you allow the recording of your program? Recordings can be used partially or in their entirety on, but not limited to, our social media accounts and Billerica Access Television (BATV) channels.* Yes No If yes, please indicate if there are any restrictions on use of the recording (i.e., only available for 6 months after the event, only available on BATV's channels, etc.).*To ensure that everyone in the audience can hear and enjoy the program, I agree to use a provided microphone during the presentation.* Yes In the event that the Billerica Public Library is unexpectedly closed and the engagement covered by this contract is prevented from being completed in the date specified by weather, physical disability, or any other cause beyond the control of the two parties, the speaker/performer and the Billerica Public Library shall respectively be relieved of their obligations under this contract. The parties may agree to schedule a replacement date which is mutually convenient. The inability to agree on any replacement date shall not be the cause of any damages or costs to either party to this contract. Enter your name below. This will serve as your electronic signature.*Address* Street Address City State / Province / Region ZIP / Postal Code Phone*Email* Website If different from the information above, please list the payment information for this event below, including who the payment should be made to and the address to send it. This can also be satisfied by a separate invoice.*Are you seeking permission to sell anything and if so what?*I understand payment cannot be made until I submit a completed W-9 to Sharon Lomison at slomison@billericalibrary.org.* Yes Δ