Contact

First Name*

Last Name*

Email Address*

Contact Number (Including Area Code)

Message* - How may we be of assistance?

First Name*

Last Name*

Email Address*

Contact Number (Including Area Code)

Message* - How may we be of assistance?

Credential Type

I am requesting the following media credentials (please check all that apply):

ReporterPhotographerNewspaperMagazineTelevisionRadioOnlineOther

Organization and Contact Information

Name of Org./Affiliate *

Point of Contact *

Title

Street Address *

City *

State *

—Please choose an option—ALAKASAZARCACOCTDEDCFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY

Zip *

Country *

Daytime Phone *

Evening Phone *

Email *

Parties Attending and Status

List names of all persons attending and their positions.

(Note: Use ONE form for all persons from same media outlet. List the individuals first and last name. Separate each individual name with a comma. Example: First, First Last, )

Show Coverage and Interviews

Which Show or Show Dates would you like to cover? - (Please check all that apply)

Thursday, August 21st (Performer Interviews)Friday, August 22nd (Media Rehearsal Show)Saturday, August 23rdSunday, August 24th

So that we can help you obtain the coverage that you need, please list any other requests below (Specific interviews, access/footage needed, special story angle, aircraft rides etc.):

Interviews

YesNo

Which acts would you like to interview?

Media Rides?

YesNo

# Requesting Media Rides - Please Specify.
*Media rides are subject to availability and may also be changed or cancelled due to weather or mechanical problems

Access/Footage Needed

YesNo

For which acts would you like access/footage?

Special story lines

YesNo

Please specify.

Special medical needs?

YesNo

Please specify.

Terms and Conditions

If provided with Wings Over Batavia credentials, I agree to provide proof that I am at least 18 years old (unless age requirement waived by an authorized representative) and provide my organization's press credentials or an official assignment letter from a bona fide media outlet. We will notify you by e-mail to confirm your credentials as well as provide you with show updates.

I understand and comply with the conditions listed on this form for receiving credentials. *

YesNo

First Name*

Last Name*

Email Address*

Contact Number (Including Area Code)

Message* - How may we be of assistance in your goals?

First Name*

Last Name*

Email Address*

Contact Number (Including Area Code - Optional)

Message (Optional)

First Name*

Last Name*

Email Address*

Contact Number (Including Area Code)

Message* - How may we be of assistance?

First Name*

Last Name*

Email Address*

Contact Number (Including Area Code)

Message* - How may we be of assistance?