Senior Citizens Center Facility Rental Request

Senior Citizens Center Facility Rental Request

Facility rental request form for the Senior Citizens Center at 402 Clough Street in Waverly, Ohio.
Renter Information
Renter Name

First NameLast Name
Organization
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Rental Details and Pricing Inputs
Renter Category
Room Selection
Number of Hours
Kitchen Access
Hourly Rate
Total Cost
Agreements and Acknowledgments
I have read and agree to follow the Senior Citizens Center regulations and facility-use rules
Acknowledgment signature
Please Note: Completing this form does not automatically reserve the facility. This form will serve as an inquriy with the information needed to inform the staff and administration of your interest in renting the facility. A representative will contact you at their earliest convenience. For more information, please call (740) 947 - 5555.
Should be Empty: