FreezerBurn 2022: Weird Science
Art Intake Form

Art Piece Name *

Associated Theme Camp
(100% Optional)

Description for Art Guide *

Total Funding Requested *

Dangerous Elements
(Select all that apply.) *

My art will be 100% safe for all hippies to enjoy without any type of warning or babysitter on duty.

My art will have fire or flame effects.

My art will have loud sound effects.

My art will have flashing or strobe light effects.

My art will be dangerous, but the type of danger I anticipate is not listed here.

Special Danger Posed *

Art Piece Dimensions (L' x W' x H') *

Transportation Needs *

I will provide my own transportation.

I will need help getting my art to the FZB land.

On-site Assistance Needed
(Select all that apply.) *

I got this - no assistance needed.

I will require use of a VR during install.

I will require additional power during install.

I will require additional power to run my art throughout the event.

I will require additional power during tear-down.

Additional Power Needed During Install *

Additional Power Needed Throughout Burn *

Additional Power Needed During Tear-down *

Build Plan *

Install Plan *

Tear-down Plan *

Breakdown of Materials & Cost *

Attach supporting documentation.

Team Contact information

Project Lead Legal Name *

Project Lead Burner Name

Project Lead Preferred Contact *

Email

Text (SMS)

Project Lead Email Address *

Project Lead Phone *

Grant Funds Disbursement

Preferred Method for Funds Disbursement *

Paypal

Check

Paypal Email
(In case of issues with PayPal, we will send a check!) *

Mailing Address *

Address Line 2

City *

State *

Zip Code *

Additional Team Members
(include email and/or phone if team member wants to be copied on art communications)

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FreezerBurn 2022: Weird ScienceArt Intake Form

Team Contact information

Grant Funds Disbursement

FreezerBurn 2022: Weird Science
Art Intake Form