Event Room Only Request Form
Name
*
First Name
Last Name
Company Name
Company Name (if applicable)
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Email
*
example@example.com
Event Type
*
Tier 1: Use of Event Room During Arcade's Normal Operating Hours
Tier 2: Use of Event Room While Arcade is Closed (Available during specific hours only.)
Date Requested
*
/
Month
/
Day
Year
Date
Start Time Requested
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
30
Minutes
AM
PM
AM/PM Option
Additional Time
None
1 half-hour (2 Hours Total)
2 half-hours (2.5 Hours Total)
3 half-hours (3 Hours Total)
4 half-hours (3.5 Hours Total)
5 half-hours (4 Hours Total)
Other (Please fill in details in the Message below.)
Tier 1 and Tier 2 are 1.5 Hours long. Select additional half-hour blocks, if desired.
Room Layout (See pictures above)
Layout A
Layout B
Layout C
Layout D
Message
Submit
Should be Empty: