Community Partner Event Request Form

Please submit requests at least one month before your event date.

Need to finish later? Click Save at the bottom before leaving this form. Copy your personal return link or choose to have it emailed to you, then open that link when you are ready to finish. Keep your link private. Your request is not submitted until you click Submit Event Request.

Organization Name

Contact Person

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email Address

example@example.com

Preferred Contact Method

Organization Website / Social Media

Is the on-site emergency contact the same person and phone number listed above?

On-site emergency contact name

On-site emergency contact mobile number

Please enter a valid phone number.Format: (000) 000-0000.

Event Name

Planning an event less than 30 days away?

Please call Family First Center of Lake County at 224-421-0948 to discuss your request.

Preferred Event Date

Date

Staff override code

Staff use only. Leave blank unless Family First Center staff provided a code.

Staff Event Date

Date

Preferred Start Time

Hour Minutes

AM/PM Option

Preferred End Time

Hour Minutes

AM/PM Option

Event Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Estimated Attendance

Population Served

Is this event indoors or outdoors?

If this event is outdoors, please describe your rain or inclement-weather backup plan.

Will electricity be available at the event location?

Please explain how power needs will be handled.

Will bathrooms be available on site?

Will you or your attendees require accessibility accommodations?

Please describe the accessibility needs or special accommodations.

Why is this event important to your community?

Parking & Setup Access

Games & Activities

Hot Food & Concessions

Additional Services

Setup Needs / Space Considerations

Additional Comments or Special Requests

Location Commitment

Promotion Commitment

Coordination Commitment

Photo / Video Permission

Authorized Representative Name

First NameLast Name

Agreement Date

Date

Acknowledgement

Organization Information

Event Information

Requested Services

Event Details & Notes

Partner Agreement