Facility Rental Request Form
Contact Information
*
First Name
Last Name
Phone Number:
*
Format: (000) 000-0000.
Email:
*
example@example.com
Date of Event Option 1:
*
-
Month
-
Day
Year
Date
Date of Event Option 2:
*
-
Month
-
Day
Year
Date
Time of Event Starts:
*
Hour Minutes
AM
PM
AM/PM Option
Time of Event Ends:
*
Hour Minutes
AM
PM
AM/PM Option
Do you currently have a household account with Bloomingdale Park District?
*
Yes
No
Is the person filling out the form, the account holder?
*
Yes
No
Notes
Please give a brief description of the event
Rental Application Options
JRC Room rental Application
JRC Party Package Application
Please upload completed application here:
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