Facility Rental Request

1. First Name

2. Last Name

4. Phone Number

5. Address

6. E-mail Address

7. Renter's D.O.B. This question requires a valid date format of MM/DD/YYYY.

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8. Type of Event, additional information or details *This question is required.

9. Preferred Date #1 This question requires a valid date format of MM/DD/YYYY.

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10. Copy of Preferred Date #2 This question requires a valid date format of MM/DD/YYYY.

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11. Copy of Copy of Preferred Date #3 This question requires a valid date format of MM/DD/YYYY.

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12. Estimated Number of People *This question is required.

13. Start time (This begins when walking in, or the "walk-in time," and includes setting up decorations, tables, and chairs)

End time (Or last person walking out, after cleaning up room and putting away tables and chairs) The renter is responsible for taking down decorations and throwing away any trash.
*This question is required.

14. Sign Here *This question is required.

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Signature of

15. I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent. *This question is required.

I agree