Room Rental Application Form
Applicant/Company Name
First Name
Last Name
Date of birth
-
Month
-
Day
Year
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Do you understand this is a kid friendly, none-smoking environment?
Yes
No
Emergency/Secondary Contact
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Reference (If none, fill in your name)
Name
First Name
Last Name
Use/Reason for space
Describe rehearsal and/or event, include 3 dates (date needed + 2 optional dates)
Payment Method
What Payment Method do you plan to use?
Cash
Zelle
Paypal
Other
Which of our equipment do you plan to use?
Projector & Screen
Chairs
Sink
Mirrors
Tables
Will you be able to stay and assist cleaning?
Yes
No
Submit
Should be Empty: