Organization/Group Name
Main Contact
Street Address
City State ZIP
Email Primary Phone
Website (if applicable)
Day of Event Contact Person Cell Phone
Performers/Group Name Number of Performers
Type of Entertainment: Dance Music Martial Arts Other
Provide Description of Entertainment:
Time Preferred (Rank Choices) - Rank each from 1 (best) to 5 (not ideal)
12pm-1pm 1pm-2pm 2pm-3pm 3pm-4pm 4pm-5pm
Performance Length:(Performances should be 15 minutes or less. 15 minute maximum includes setup, performance and cleanup)
Setup: mins Performance: mins Cleanup/Strike: mins
Performance Requirements: (Check the box/indicate number of each item needed)
Describe Other Requirements:
Submit 2-3 sentences about your group/performance and related culture or country. This may be used in marketing materials or to announce each group to provide education to the audience:
If you performed in Culture in the Community previously, how will your performance or group differ this year? If you have not participated before, please write "New Performer."
I, the undersigned, in consideration of participation in Culture in the Community, agree to defend, indemnify, release, and hold harmless the City of San Ramon and its employees from any and all liability for damages, both actual compensatory and consequential, including by not limited to damages for personal injury, including death, as well as for damages to property, which may arise out of participating in this event.
The City further reserves the right to assign performance locations and/or deny any entries based on policies.
Name Date
Security Measure