Community Troupe Application

*required information

Requestor Information

Name/Title*	Required Company* Required Dept.* Required
Address*	Required KP Service Area
City*	Required State* Required Zip Code* RequiredInvalid format.
Phone/Cell*	RequiredInvalid format. E-mail* RequiredInvalid format.

Event Information

Event Date*:		Event starts: RequiredInvalid format. Event ends: RequiredInvalid format.
Event Name*:	Required
Event Location*:	Required
Event Address*:	Required
Event Contact*:	Required Phone/Cell* RequiredInvalid format.
Stage Manager/Coordinator:	Phone/Cell Invalid format.
Logistics Contact:	Phone/Cell Invalid format.
Purpose of Event:
Sponsors:
Type of Event:	HEAL-CHI HEAL-Local Partnership/Collaboration Community Event
Special Guests:
Anticipated Attendance:	Adults Youth

Performance Request

Please check all that apply. Please note that the All-Star Mascot Show and the Kids' Course cannot be offered on the same day.

Mascot Ambassador
Each Mascot Ambassador conducts a meet-and-greet segment for up to 2 hours (minimum 15-minute break between 30-minute sets). Multiple Mascot Ambassadors subject to staff availability. Other timeline options can also be discussed.
Boring G. Boring Cardio Heart Nikki NutriBeast Super Weevil

All-Star Mascot Show
The All-Star Mascot Show features a series of vignettes that engage audience members' imaginations to inspire healthy changes.

Kids' Course (Indoors or Outdoors)
For ages 5-12, the Kids' Course utilizes interactive elements that teach vital health messages and encourage physical activity.

Other Product
Minimum number of selections not met.

Logistical Information

Based on your Performance Request selection, please complete the logistical information that corresponds with your request(s).
Mascot Ambassador - This product requires 45 minutes to prep prior to start time.
Start Time:	End Time:
Changing & Rest Area:	Please note restrooms are not appropriate for mascot changing or storage areas Breakroom Classroom Conference Room Office Other No private area available; bring changing tent. Location where we can set up tent:

All-Star Mascot Show (Performed indoors or outdoors) - This product requires 90 minutes to prep prior to start time.
Performance Space Requirements:	12'L x 12'W x 12'H
Performance Location:
Audience Seating:	Bleachers Chairs Floor Other
Is a Sound System Provided?	Yes No Please note that we require an additional 30 minutes for set-up and an additional 20 minutes for breakdown when we provide the sound system.
Show Times:	1) 2) 3)


Kids' Course (Performed indoors or outdoors)
Start Time:	End Time:
Performance Space Requirements:	30'L x 30'W x 15'H
Performance Location?	Indoors Outdoors
Surface:	Cement Dirt Grass Clay Carpet Hardwood Floor Other
# of Volunteers available:

Directions
Freeway Driving Time: Minutes from Freeway: Estimated Total Driving Time:

Please provide directions to your event. Our cast will be traveling from downtown Oakland.
(Please be specific and use Right and Left when describing turns, rather than North, South, etc.)