Your Name/Organization: (Name of Person, Company, or Organization legally bound by the rental contract (Licensee))

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RENTAL REQUEST FORM Your Name/Organization: (Name of Person, Company, or Organization legally bound by the rental contract (Licensee)) Name of Person, Company, or Organization appearing at event if different from above: Primary contact (if different from above): Mailing address (including postal code): If your organization is a Not for Profit entity, please provide CRA Registration Number or Certificate of Incorporation: Primary phone number: Alternate phone number: E-mail: Primary Website or Social Media* Profile: *If Social Media, what platforms (Twitter, Facebook, Instagram, etc): PLEASE NOTE THAT THE CITADEL THEATRE RESERVES THE RIGHT TO DECLINE RENTAL OF OUR FACILITIES FOR ANY EVENT OR TO ANY PARTY WHERE SUCH RENTAL MAY BE DETRIMENTAL TO THE BEST INTEREST OF THE CITADEL THEATRE AND ITS PATRONS. THE DECISION TO RENT ANY SPACE IN THE CITADEL THEATRE COMPLEX IS AT THE SOLE AND COMPLETE DISCRETION OF THE CITADEL THEATRE. Preferred Event date: Preferred Venue: The Club The Club Lobby The Tucker Amphitheatre The Zeidler Hall The Maclab Theatre Nature of Event: Lecture Film Screening Corporate Reception Christmas Party Dance Recital The Shoctor Lobby The Shoctor Theatre The Boardroom Other (please specify): Meeting / Town Hall Conference Other (please specify):

PLEASE NOTE THE FOLLOWING REQUIREMENTS: 1. You must provide the Citadel Theatre with a certificate of liability insurance with minimum limit of $2,000,000.00 per occurrence for the duration of your event. Such certificate must be received in accordance with the time lines and loss payable provisions outlined in the Facilities Rental Agreement or your event may be subject to refusal. 2. Advertising for the event may not begin until the Licensee has signed and returned the rental contract, provided evidence of liability insurance, and a deposit payment has been processed by the Citadel Theatre. 3. The Citadel Box Office Ticketing Services must be used for all ticketed events. Number of guests expected: Will you require accessible seating? If so, estimate how many: Rental (set up) start time: Guest arrival time: Event start time: Breaks or intermission times (if any): Event end time: Rental end time (Please allow an appropriate amount of time in which to pack up and load your event items): PLEASE NOTE THAT THE CITADEL IS A SCENT FREE BUILDING. FOR THE SAFETY OF THOSE WITH ALLERGIES, PLEASE ADVISE YOUR GUESTS TO REFRAIN FROM THE USE OF PERFUMES OR SCENTED PRODUCTS BEFORE COMING TO THE CITADEL. EVENT INFORMATION Please provide a detailed description of your event. Please include any further information that you think we may need to ensure the success of your event, including the attendance of media or any VIP guests: Will you have your own volunteers at your event? YES If YES, how many? What are their responsibilities? Please describe: NO

TICKETING Are you selling tickets to your event? YES NO If no, are you giving away tickets to your event? YES NO If yes, this is considered a ticketed event, and Box Office fees will apply **Please note that all sales must go through The Citadel Theatre Box Office** **ANY EXCHANGE OF FUNDS, INCLUDING DONATIONS, FOR TICKETS IS CONSIDERED SELLING OF TICKETS** Do you wish the Citadel Theatre to submit GST to Canada Customs and Revenue Canada on your behalf? YES NO If yes, please provide your GST Registration number: TECHNICAL REQUIREMENTS Do you require any of the following equipment (Charges may apply to some of these items.) Hard Wired Mic with Stand ($75 / each) YES NO Number required: Hard Wired Mic with Lectern ($75 / each) YES NO Number required: Wireless Mics ($100 / EACH) YES NO Number required: Lapel Mics ($100 / EACH) YES NO Number required: Tuned Grand Piano ($300): YES NO Tuned Upright Piano ($200): YES NO Blue Ray or DVD Player ($25 / each) YES NO Number required: Roll Up Projector Screen ($30 / day) YES NO Short Throw Projector Set Up ($150) YES NO 55 LCD Presentation Screen YES NO Number required: ($175 for 1 OR $300 for 2) **For use in the Club Lobby, Shoctor Lobby, Tucker Amphitheatre or Boardroom** Large Format Projector and 10 x 17 Wide Screen ($800 per event) **Available for use ONLY in the Maclab, Shoctor or Club** YES NO Shaw Business Internet ($150 per event) YES NO **Available in the Maclab Theatre, Shoctor Theatre or Zeidler Hall ONLY** 3

PROGRAM REQUIREMENTS Please describe the format for your video program? (powerpoint, movie, dvd, etc) Does your presentation require sound? YES NO How many speakers will you have? What is the length of each speaker s presentation (approx.) How many people do you anticipate backstage Will there be a musical performance component to your event? YES NO If so please describe in detail: PHOTOS / VIDEO Are you hiring a photographer or videographer? YES NO Name of photographer / videographer Phone number Email **Please ensure your photographer/ videographer arrives at least 30 minutes prior to the event start time. Failure to arrive at the event 30 minutes prior to the start may result in the photographer/videographer being denied entry** MERCHANDISE Are you selling merchandise at your event? YES NO What kind of merchandise will you be selling? Please list each item along with what you will be charging for each item: How many tables will you require for your merchandise? **Please note that if you are selling any merchandise, the Citadel reserves the right to retain 15% of all merchandise sold** 4

CATERING Is there a catering component to your event? YES NO Name of caterer: Phone number: Name of contact at catering company: What is the estimated time of arrival for the caterer? Does the caterer require a prep area? YES NO If so, how many 6 tables are required? How many tables will the caterer require for all the catering items they will be providing to your guests? Will the caterer be responsible for bussing tables? YES If NO, who on your team will be responsible for doing this task? If the caterer is just dropping & going, who on your team is responsible for packing up any leftover food / drink items and / or catering equipment? What time will the caterer be picking up their left supplies / equipment? If rentals of catering equipment, china, glassware, etc are required, what time will the rental company be dropping off and picking up these these items? DROP OFF TIME PICK UP TIME Name of rental company Phone number: Name of contact at catering company: NO ADDITIONAL ITEMS 6 Rectangular Tables ($20 / each) YES NO How many? 4 Round Tables ($20 / each) YES NO How many? Cocktail / Cruisers Tables ($20 / each YES NO How many? Do any of the tables require linen? YES NO How many? ($5 per linen) 5

Folding Chairs ($2 / each) YES NO How many? Easels ($15 / each) YES NO How many? Coat racks ($25 each) YES NO How many? (Each rack holds approx 25 items) Do you require a staffed coat check? YES NO ($25 per hour / per person) Thank you for submitting your rental request form. Due to the heavy volume of arts and cultural programming in our venue, making a final decision about which inquiries we can accommodate often involves consultation between multiple departments, depending on the time of year and scope of the event proposed. We aim to respond to your booking request within 2 business days, but it may take more than 4 business days for the inquiry to circulate amongst the various departments concerned. We thank you in advance for your patience. Please either fax, 780.428.2130 or email your completed Rental Request Form to your rental representative or to rentals@citadeltheatre.com Sincerely, The Rentals Department Disclaimer - No booking is finalized until receipt of signed contract, certificate of liability insurance is provided, and deposit is paid and processed in full by the Citadel Theatre. In the event that facts or information arise that change the scope, nature, or risks of your event after receipt of the signed contract, processing of deposit and furnishing of insurance, your event may be re-evaluated for fees or suitability. 6