Rock The Block 2023 Partner Registration Form

Rock The Block 2023 Partner Registration Form
Date*

MonthDayYear
Date
Name*

First NameLast Name
Company Name*
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Would you like for us to mail you event postcards?*

YesNo
Website*
Instagram*
Tik Tok
Facebook
Are you the event day point of contact? If no, please provide event day point of contact below.*

YesNo
Event Day Contact Name:

First NameLast Name
Event Day Contact Email Address:
example@example.com
Event Day Contact Cell Number:*
Please enter a valid phone number.
If you have a communications or social media person, please share their email:
example@example.com
Partnership Level*

Presenting Partner $25,000Title Partner $15,000Sports Zone Partner $10,000Health Zone Partner $7,500Parent Zone Partner $5,000Educational Zone Partner $5,000Kids Zone Partner $5,000Fitness Zone Partner $5,000Tech Zone Partner $2,500Art Zone Partner $4,000
Please provide Partnershp payment via check to:

White Hall Arts Academy Foundation
2812 W 54th Street
Los Angeles, CA 90043
Ph: (424) 235-0665
Email: foundation@whitehallacademy.org
Tax Id: 82-3929258

Payment can also be made via Zelle to foundation@whitehallacademy.org
Please share a 2-3 sentence blurb about your company and any activities you'll be offering at your booth. We may use this on our website and social.*
Rock The Block Event Day Point of Contact:

Eboné Starling

Ph: (404) 647-3850

Email: ebbymmg@gmail.com

Please upload high-res PNG of your logo and at least one (1) images of your business or service below.
Partner to provide:

Point-of-sale system (i.e. square reader)
Sellers permit (if applicable)
Product(s) (if applicable)
Booth signage
White Hall Arts Academy to provide:

10’x10’ Canopy tent
(1) 6ft table
(2) folding chairs
(1) tablecloth
If you have a branded 10'x10' canopy tent you would like to bring, please upload a picture here.

Please upload a high resolution jpg, png, or pdf of your branded 10'x10' canopy tent.
Cancelof
Logo File Upload*

Please upload a high resolution png file of your logo.
Cancelof
Partner File Upload 1*

Please upload a high resolution png file of your product or service.
Cancelof
Partner File Upload 2

Please upload a high resolution png file of your product or service.
Cancelof
Image Usage

I agree to allow event organizers to use the images I submit for this event for the purposes of marketing, promotion, or display.

Consent to Photograph /Videotape / Interview Individuals

Terms & Conditions

I hereby agree and give my permission for White Hall Arts Academy Foundation and/or partners to record, film, photograph, audiotape or videotape myself (hereinafter collectively referred to as “Works”) and to display, publish or distribute these Works for the purpose of publishing, posting on the White Hall Arts Academy Foundation and Rock The Block websites and posting on social media sites. I hereby waive any right to approve the use of these Works now or in the future, whether the use is known to me or unknown, and I waive any right to any royalties related to the use of these Works. I understand that the Works may appear in electronic form on the internet or in other publications outside of the White Hall Arts Academy Foundation’s control. I agree that I will not hold the White Hall Arts Academy Foundation responsible for any harm that may arise from such unauthorized reproduction.
Name*

First NameLast Name
Signature*

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