Single-License Screening Requests

Host a Screening of Charlie vs Goliath!

Charlie's inspiring story is bringing audiences together nationwide. You can be a part of the movement! For a $200 licensing fee, you will receive a DVD and screening kit, which will include everything you need to make your event successful.
Name of Screening Organizer

First NameLast Name
Title or Role of Screening Organizer
Volunteer, Student, Events Manager, Executive Director, etc.
Official Name of Hosting Organization
Hosting Organization Website
Partnering Organization(s)
Email
example@example.com
Phone Number

Area CodePhone Number
Expected Audience Size
How many people do you anticipate will attend your event? This can be a rough estimate!
Date of Screening

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Time

:HourMinutesAM/PM Option
Official Name of Venue
Venue Address

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Access
Tickets
Shipping Address (We'll ship the DVD here)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Licensing Agreement$200.00

Total $0.00

PUBLIC PERFORMANCE RIGHTS

Please read the below Licensing Agreement carefully, and mark a check next to ALL licensing terms to indicate your understanding of each.
AGREEMENT
RIGHTS AND PAYMENT
DEFINITION OF PUBLIC EXHIBITION
RESERVATION OF RIGHTS
SUBLICENSE
ALTERATIONS
REFUNDS AND RETURNS
DISCLAIMER OF WARRANTY
COMPLETE AGREEMENT
Signature

Use your mouse or finger to draw your signature above
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Host a Screening of Charlie vs Goliath!