50501 Harrisburg Pennsylvania Event Performance Request Form
Please complete this form to perform at a future 50501 Harrisburg event & we will be in touch.

For more information/contact: https://lnk.bio/50501Pennsylvania

Thank you! See you in the streets!
Sign in to Google to save your progress. Learn more
Applicant's Full Name *
Applicant's Phone # *
Applicant's Email *
I'd like to be a chanting team member and help lead or elevate chants!
Clear selection
How many people are in your performance group? *
Type of Performance *
Your Stage/Band/Group Name
How would you like to be introduced? 
(Ex. Belinda Chandra from Harrisburg PA is a local lifelong disability activist who has been arrested more than 10 times for civil disobedience and is here to share her story.)
 *
What is your availability to perform? *
Are you or your group interested in also tabling/tent or volunteering? *
Would you be able to be a backup performer in case of cancellation on the day of the rally?
 (Ex. You'll be there already and you'll be prepared with your performance.)
 *
Do you have any requirements?
(Ex. Lodging, assistance, or expenses)
 *
I have read the Performers Pledge below and agree to follow the following guidelines.

1) I am committed to a safe and non-violent protest.
2) I will not use any open flames.
3) My performance will be family friendly.
4) I will ensure my performance sticks to the talking points of the event theme.
5) I commit to being at the event an hour prior to start for verbal run through and sound check.
 *
Performer's Social Media Accounts
(Ex. TikTok: @50501movement)
If you've been in contact with a 50501 organizer already, what is their name?
PA County of Origin of the Performer/Group if outside of Dauphin County.
Any other information you'd like us to know?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms