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
Date
Time

:HourMinutesAM/PM Option
Official Name of Venue*
Venue Address*

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Access*

Open to the publicPrivate
Tickets*

FreeAdmission fee or donation requiredWe will not charge a required admission fee, but we will collect donations
Shipping Address (We'll ship the DVD here)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Licensing Fee*

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*

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