You must have JavaScript enabled to use this form. Advertiser Information Company Name Contact Name Billing Address City State Zip Phone Number Email Address Advertising Summary Select Ad Type (Please select one) Basic Static - $650/mo Basic Video - $650/mo Premium Video - $750/mo Ticket Sponsor - $2,500/mo Addendum / Custom Package Theater Selection Warehouse Cinemas Frederick Warehouse Cinemas Leitersburg All Locations *Not sure which market to target? Why not both! Advertise at both locations and enjoy 10% off. Select Months January February March April May June July August September October November December Select all months Billing Summary Payment must be no later than 14 days prior to advertisement date. Take a look at our terms and conditions to learn more. Checks should be made payable to HighRock Studios or credit card info can be provided over the phone. Billing Preference Monthly Quarterly Annually Purchase Order # (if applicable) Authorized Signature Your Full Name Acceptance of Contract - Please type your initials