Live, In-Person Show Registration
Your registration is not complete until you complete all required fields, select a show date and time, and click the SUBMIT button at the bottom of the form. If you require assistance completing the form or have any questions, please contact us at admin@eme.llc OR mbeane@roadradiousa.net
Name of School or Youth Organization
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Your Name
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First Name
Last Name
Title
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What is your role at your school or organization?
Phone Number
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Please enter a valid phone number.
What is the best time for Road Radio USA to contact you?
Approximately how many youth will attend this event?
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Use the Calendar Below to Select the Date and Time for Your FREE In-Person Show:
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What are the ages and/or grade levels of youth who will attend this event?
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How many adults will attend this event?
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Venue Information
Name of school or other venue where Road Radio USA will perform
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Address of school or other venue where Road Radio USA will perform
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Note our Venue Requirements
The Road Radio USA program incorporates music and audio, video, and other visual components. We bring an assortment of professional equipment, including projectors, rear-projection screens, lighting, speakers and more that must be transported on wheeled carts. As a result, all shows must occur either in a weather-proof covered outdoor space (such as a bandshell or pavilion) or an indoor facility such as an auditorium, theater, gymnasium or other large meeting space. The space must also be wheelchair accessible and have electric service.
Please indicate the option below that best describes the venue where the Road Radio USA presentation will occur.
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Indoor - Wheelchair access, electric service with stage and/or podium.
Indoor - Wheelchair access, electric service with NO stage and/or podium.
Outdoor - Covered space w/wheelchair access, electric service with stage and/or podium.
Outdoor - Covered space w/wheelchair access, electric service with NO stage and/or podium.
Where and with whom should the Road Crew check in when they arrive at your facility?
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The Road Radio USA Road Crew includes Jimbo in Stereo, his driver/event photographer Ron Johnson, and DJ Big Andy and his assistant.
The Road Crew will arrive in 2 separate vehicles.
Jimbo and Ron will arrive approximately 30 minutes prior to the scheduled show time. DJ Big Andy and his assistant will arrive approximately 3 hours prior to the scheduled show time for equipment setup.
Please confirm that members of the Road Crew will have access to the venue 3 hours prior to the event for equipment set-up.
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I confirm that the Road Crew will have access to the venue at least 3 hours prior to the scheduled show time.
Photo and Video Authorization
Road Radio USA uses pictures & short videos from events on our website, social media & promotional materials. This may include images of youth, staff & other individuals who attend.
Does Road Radio USA have authorization to share photos and videos taken during this event?
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Yes. Road Radio USA can use photos and videos from this event on the Road Radio USA website, social media, and other promotional materials.
No. Road Radio USA can NOT use photos and videos from this event on the Road Radio USA website, social media, and other promotional materials
Additional Information
Is there anything else we need to know about your school or youth organization prior to your event?
How did you hear about us?
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We'd love to know who to thank for bringing us to your school or youth organization!
ATTENTION! AFTER you submit your Event Date/Time in Calendly, below, you MUST scroll to the bottom of this form and click the green SUBMIT button. Your registration is not complete until you click the submit button!
After you submit your registration, you will receive a confirmation from Calendly AND JotForms.
Your registration is not complete until you click the submit button!
After you submit your registration, you will receive a confirmation.
Road Radio USA Newsletter Subscription Opt-In
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Yes! Please subscribe me to the Road Radio USA Newsletter
No. Please do not subscribe me to the Road Radio USA Newsletter
Submit
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