Name of Screening Organizer *

First Name

Last Name

Screening Date *

Indicate the date of the screening(s). Please be sure to leave at least 3 weeks before the screening date.

MM

DD

YYYY

Venue Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Shipping Address (Where we'll ship your DVD) *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

RIGHTS AND PAYMENT (Please check the box below) *

Licensor hereby grants to Licensee the non-exclusive, and revocable license to exhibit the Film in a public exhibition to be directly sponsored, co-sponsored, hosted, or presented under the auspices of the Licensee named herein. The Total Fee ("Fee") indicated in the Application shall become due and payable at least 10 business days prior to the date of first exhibition. If the Film arrives in unplayable condition, Licensee may request a new copy be sent, so long as this request is made within 7 days of the date unplayable copy is first delivered. In such a case, Licensor has the option to cancel the contract with 7 days of the date the request is made and return all money paid, or resend within 7 days of such request.

DEFINITION OF PUBLIC EXHIBITION (Please check the box below) *

The public exhibition of the Film shall be defined as any display, performance, viewing, screening, or playback of the Film occurring at a place open to the public or at any space where a substantial number of persons outside of a normal circle of a family and its social acquaintances is gathered. Public exhibition does not apply to any broadcast, cable, or satellite transmission of the film, nor any exhibition of the film in which all viewers and playback equipment are not in the same room or venue. Licensor acknowledges that the Film may be exhibited before an audience to which an admission fee is being charged.

RESERVATION OF RIGHTS (Please check the box below) *

The public exhibition of the Film shall be defined as any display, performance, viewing, screening, or playback of the Film occurring at a place open to the public or at any space where a substantial number of persons outside of a normal circle of a family and its social acquaintances is gathered. Public exhibition does not apply to any broadcast, cable, or satellite transmission of the film, nor any exhibition of the film in which all viewers and playback equipment are not in the same room or venue. Licensor acknowledges that the Film may be exhibited before an audience to which an admission fee is being charged.

SUBLICENSE (Please check the box below) *

The public exhibition of the Film shall be defined as any display, performance, viewing, screening, or playback of the Film occurring at a place open to the public or at any space where a substantial number of persons outside of a normal circle of a family and its social acquaintances is gathered. Public exhibition does not apply to any broadcast, cable, or satellite transmission of the film, nor any exhibition of the film in which all viewers and playback equipment are not in the same room or venue. Licensor acknowledges that the Film may be exhibited before an audience to which an admission fee is being charged.

ALTERATIONS (Please check the box below) *

The public exhibition of the Film shall be defined as any display, performance, viewing, screening, or playback of the Film occurring at a place open to the public or at any space where a substantial number of persons outside of a normal circle of a family and its social acquaintances is gathered. Public exhibition does not apply to any broadcast, cable, or satellite transmission of the film, nor any exhibition of the film in which all viewers and playback equipment are not in the same room or venue. Licensor acknowledges that the Film may be exhibited before an audience to which an admission fee is being charged.

REFUNDS (Please check the box below) *

In the event that Licensee must cancel a public exhibition, Licensee may cancel this Agreement, and is entitled to a full refund of the licensing fee indicated below, less all original shipping, handling and customs fees, provided that the refund is requested within 7 days of receipt of the Film. Cancellation and refund requests made more than 7 days after receipt of the Film cannot be honored. Refunds will be processed within 2 business days after receipt of the returned screening formats, which must be in the original condition in which they were received.

DISCLAIMER OF WARRANTY (Please check the box below) *

LICENSOR MAKES NO WARRANTIES EXPRESS OR IMPLIED WHATSOEVER, AND ALL IMPLIED WARRANTIES INCLUDING THE WARRANTY OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE ARE HEREBY DISCLAIMED. Licensor shall have no other obligations, and licensee shall have no other recourse other than that specifically stated in this Agreement.

COMPLETE AGREEMENT *

This Agreement sets forth the entire and complete agreement and understanding between the parties and supersedes all prior agreements or understandings, written or unwritten.