Full Name:
*
First Name
Last Name
Phone Number:
*
-
Area Code
Phone Number
Email Address:
*
Confirmation Email
Company (If Applicable):
Tax Exempt
Yes
No
Desired Date
*
-
Month
-
Day
Year
Date
Desired Start Time
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Desired End Time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Number of Hours Total (Must Include Set Up/Clean Up)
*
Please Describe Your Event: Include All Event Details and Preferred Venue (After 8/15, East Liberty will be children friendly events only, Southside Adult Events only)
*
Which of the following are being requested?
All Inclusive Rental
Basic Rental
Smoking
Southside Venue
East Liberty Venue
Budget— Please Review Pricing On Website And Include Total Amount Budgeted
*
Expected # of Guests
*
Have You Reviewed Policies and Pricing? You will be held to all policies.
*
Are you ready to make the half deposit to secure your date? (If your inquiry date is within 3 weeks, the full amount is due upon booking)
*
All Renters Must Be 21+. Are you 21+?
*
Yes
No
I certify that the above is accurate and I am aware that I will be held to the above standards.
Signature
Clear
Submit
Should be Empty:
Now create your own JotForm - It's free!
Create your own JotForm