Name *
Phone *
Date Requested
Date Requested
Space Interested In *
Will your event need food or drink service? *

This submission is a not a guarantee for reservation of space. You will be contacted within one week of receipt to discuss your event. A deposit will be required if a hold or confirmation is agreed upon.

* If you are, or represent an artist who has interest in playing the 04 Room, please send an email with your info to