Organization Name:
*
Full Contact Name:
*
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number:
*
Please enter a valid phone number.
Alternate Phone Number:
Email:
*
Organization Type:
*
Business, Church, School, etc
Total Attendees:
*
How Many People Are Coming?
Brenden Theatre Location:
Please Select
Las Vegas, NV
Kingman, AZ
Rifle, CO
Laughlin, NV
Vacaville, CA
Modesto, CA
Concord, CA
Movie Title:
*
Pick A Good One!
Concessions:
This Is The Best Part!
Preferred Event Date:
*
-
Month
-
Day
Year
Alternate Event Date:
-
Month
-
Day
Year
Event Time Start:
*
When Does The Party Start?
AM
PM
AM/PM Option
Event Time End:
*
When Does It End?
AM
PM
AM/PM Option
Additional Comments:
Any Thing You Think We Should Know?
Confirm You're Not a Robot From The Future
*
Submit
Should be Empty: