CheckMate Request Form
Please fill out this form completely in order to submit your request. Completion of this form does not guarantee an appearance.

Some guidelines for a CheckMate appearance at your event:

- Secure parking and a dressing room must be provided for CheckMates (no public
restrooms, please). In some cases, it may be necessary to provide water.

- Appearances are for everyone’s enjoyment. Please help to keep the event fun by maintaining a safe
and fan-friendly environment. CheckMates reserve the right to walk away from any
appearance they deem unsafe or harmful. (No refunds)

- Rates for CheckMate appearances vary depending on the type of event. Completed request forms
should be received at least (4) weeks prior to event date.

- Once request has been received by the Charlotte Checkers, you will receive an invoice letter or email
confirming or denying the request within (10-14) business days.

- All payments must be received at least (5) business days prior to the event.

Email Address *
Your answer
Name of Requesting Organization *
Your answer
Organization's Address *
Your answer
Main Contact Name *
Your answer
Contact Mobile Phone *
Your answer
Event Name/Title *
Your answer
Event Date *
MM
/
DD
/
YYYY
Event Time *
Time
:
Length of Event *
Your answer
Event Location *
Your answer
Event Address *
Your answer
Event Description (please be specific: audience size, age, theme, etc.) *
Your answer
CheckMate Role in Event *
Your answer
Number of CheckMates requested *
Your answer
Appearance Start Time *
Time
:
Length of Appearance *
Your answer
Detailed Directions to Event *
Your answer
On-Site Contact *
Your answer
On-Site Contact's Mobile Phone *
Your answer
Are you inviting local media? *
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