Event Facility Request

Event Facility Request
Contact Details
Name of person in charge of Event:

First NameLast Name
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:
Email:
example@example.com
Event Details
Type of Event
Number of Guest(s) Expected:
Date of Event:

MonthDayYear
Date
Time of Event Starts:

Hour Minutes

AM/PM Option
Time of Event Ends:

Hour Minutes

AM/PM Option
Setup Time:

Hour Minutes

AM/PM Option
Breakdown Time:

Hour Minutes

AM/PM Option
Do you need sound?

YesNo
Will there be an Admission/Registration charged?

YesNo
Confirmation of the Request:
Printed Name:
Renter's Signature:*

Clear
Date of Signature:

MonthDayYear
Date
Should be Empty: