Roth Media Inquiry Form
Thank you so much for reaching out! We are so excited to learn more about your event.
Sign in to Google to save your progress. Learn more
Event Name
First & Last Name
 *
Email Address
 *
Phone Number
 *
Event Details
Event Date
MM
/
DD
/
YYYY
Additional event information?
Start Time
Time
:
End Time
Time
:
Event Location
 *
Services Required
 *
Please select all the apply

Required
Venue Contact
If possible, please provide us with a contact from the chosen venue.
Billing Information
Please provide us with proper billing information
Photography
Our standard edit turnaround time is 48 hours. This may be longer during peak seasons such as Holiday and Summer Events. Please advise if you need the images sooner as expedited fees may apply. 

Please skip ahead to the next section (Photo Booth) if photography is not needed for your event.
Type of session
Clear selection
Photo Booth
  • Props, staff and digital customization included 
  • Please allow for 90 minutes for set up and 60 minutes for tear down. 
  • Nearby power outlet or power drop required 
  • Footprint: 12x12 or 12x15 with props table 
Please skip ahead to the next section (360 video booth) if photography or Photo Booth are not needed for your event.
Which Photo Booth package are you looking for?
All packages include staff, text/email photos, gifs & boomerangs, green screen, party props, custom watermark & touch screen options. Full day packages cover up to 8 hours on site, if more is required you will receive a custom quote. Multi-day bookings available. 
Clear selection
Brand Your Photo Booth! Would you like to vinyl wrap the booth?
Take a look at what we can do!
Captionless Image
Clear selection
Would you like to watermark your images?
If yes, please email us your logo. Transparent background PNG at least 1000px or vector file required - contact@rothmedia.ca
Captionless Image
Clear selection
Would you like to customize your touchscreen?
If yes, please email us your logo. Transparent background PNG at least 1000px or vector file required - contact@rothmedia.ca
Captionless Image
Clear selection
Photo Booth Backdrop
Captionless Image
Clear selection
What time does the room need to be show-ready?
Time
:
Venue WiFi information (please include network name & password)
If you said "Yes" to Digital & Prints
If you said no, please skip ahead.
What size prints are you looking for?
Captionless Image
Clear selection
360 Video Booth
  • 15 x 15 x 10 ft high footprint required
  • Access to power outlet or power drop required
  • Outdoor activation's are weather dependent, client assumes the risk of a 50% cancellation fee if cancellation is required due to weather. 
Please skip ahead to the next section if the 360 booth is not needed for your event.
360 Booth
Would you like a watermark logo on the video exports?
If yes, please email us your logo. Transparent background PNG at least 1000px or vector file required - contact@rothmedia.ca
Clear selection
Royalty-free dance music is applied to all video exports by default. If you would like to choose a custom song, it must be purchased through a royalty-free site such as Premium Beat or Artist. Receipt and license info are to be sent along with the song.
All edits can feature 20 seconds of a song
Clear selection
What time does the room need to be show-ready?
Time
:
Videography
Type of session
Clear selection
Thank you so much for your answers! We are excited to work with you!
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms