| Brockville Lions Steel Band Performance Request Form |
| Event*: | |
| Organization*: | |
| Date Of Event*: | |
| Contact Name*: | |
| Mailing Address: | |
| City, Prov/State, Postal/Zip: | |
| Phone No, Cell, FAX: | |
| EMail*: | |
| Type Of Performance*: | ParadeConcert |
| Parade - Arrival, Start, Finish Times: | |
| Concert - Arrival, Start, Finish Times: | |
| Day Of Event - Contact Person and Phone No.: | |
| Set Up Location: | |
| Will Event Go Ahead Regardless Of Weather?: | YesNo |
| Will You Be Providing Refreshments For Our Band Members: | YesNo |
| If So, Please Describe What Will Be Provided: | |
| Additional Details, directions, etc: | |
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