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2. Personal Information
   Please complete the following information.
4. Recreation Center*
   -- Select One --Edison Johnson Recreation CenterHolton Career & Resource CenterI.R. Holmes, Sr. Recreation Center at Campus HillsWalltown Park Recreation CenterW.D. Hill Recreation CenterWeaver Street Recreation CenterCommunity Family Life & Recreation Center at Lyon Park
6. Full Name*
   First & Last Name
8. Date of Birth*
   Date of Birth
9. Gender*

   1. Male
   2. Female
11. Organization
12. Non-Profit (501c3)

    1. Yes
    2. No
14. Email*
16. Address*
17. Apartment #
19. City*
20. State*
21. Zip Code*
23. Home Phone*
24. Cell Phone
26. Community Family Life & Recreation Center at Lyon Park Rentals
    Rental Information

    The West End Community Foundation, Inc. schedules facility rentals at the Community Family Life & Recreation Center at Lyon Park. Please visit their website for rental information.
28. Event Type*
    What type of event are you having (ex. Wedding, Birthday Party, Reunion, etc.)?
30. Date(s) of Rental at Edison Johnson Recreation Center*
    All rental requests must be made at least 30 days in advance.
32. Which room(s) do you want to rent at Edison Johnson Recreation Center?

    1. Gymnasium (Capacity: 430, Includes use of bleachers and scoreboards)
    2. Exhibit Room (Capacity: 50, Includes use of kitchen space*)
    3. Dance Room (Capacity: 50, Includes use of kitchen space*)

    *Food fee must be paid in order to use the kitchen space
34. Expected Attendance*
36. Event Start & End Time*
    Event Start & End Time Start Time

    —

    Event Start & End Time End Time
    Rental reservations for Edison Johnson Recreation Center are available Saturday: 8:30 a.m.-6 p.m.
38. Date(s) of Rental at Holton Career & Resource Center*
    All rental requests must be made at least 45 days in advance and paid for at least 30 days in advance.
40. Which room(s) do you want to rent at Holton Career & Resource Center?

    1. Art Room (Capacity: 50)
    2. Auditorium (Capacity: 586, No food or drink allowed, Minimum of 4 hours required to rent)
    3. Computer Lab (Capacity: 50, No food or drink allowed)
    4. Conference Room (Capacity: 25)
    5. Dance Studio (Capacity: 50, No food or drink allowed)
    6. Gymnasium (Capacity: 596, Food is allowed with floor covering rental)
    7. Learning Center (Capacity: 193)
    8. Music Room (Capacity: 50, No food or drink is allowed)
    9. Senior Room (Capacity: 50)
42. Expected Attendance*
44. Event Start & End Time*
    Event Start & End Time Start Time

    —

    Event Start & End Time End Time
    Rental reservations for Holton Career & Resource Center are available Monday-Thursday: 8:30 a.m.-9 p.m., Saturday: 8:30 a.m.-6 p.m., Sunday: 1 p.m.-6 p.m.
46. Date(s) of Rental at Walltown Park Recreation Center*
    All rental requests must be made at least 30 days in advance.
48. Which room(s) do you want to rent at Walltown Park Recreation Center?

    1. Gymnasium (Capacity: 360, Includes use of bleachers, a retractable stage, scoreboard and gym divider)
    2. Mature Adult Center (Capacity: 30)
    3. Multipurpose Room (Capacity: 35, Includes use of kitchen space)
    4. Dance Studio (Capacity: 15)
50. Expected Attendance*
52. Event Start & End Time*
    Event Start & End Time Start Time

    —

    Event Start & End Time End Time
    Rental reservations for Walltown Park Recreation Center are available Monday-Thursday: 8:30 a.m.-9 p.m., Friday: 8:30 a.m.-10 p.m., Saturday: 8:30 a.m.-6 p.m.
54. Date(s) of Rental at W.D. Hill Recreation Center
    All rental requests must be made at least 30 days in advance.
56. Which room(s) do you want to rent at W.D. Hill Recreation Center?

    1. Gymnasium (Capacity: 400, Includes use of bleachers and scoreboard)
    2. Multipurpose Room (Capacity: 85, Includes use of kitchen and room divider)
    3. Dance Studio (Capacity: 25, Equipped with ballet barres, mirrors and sound system)
    4. Multi-Use Outdoor Futsal Court (Capacity: 100, Includes use of soccer goals, picnic shelter and portable picnic benches)
58. Expected Attendance*
60. Event Start & End Time*
    Event Start & End Time Start Time

    —

    Event Start & End Time End Time
    Rental reservations for W.D. Hill Recreation Center are available Monday-Thursday: 8:30 a..m-9 p.m., Friday: 8:30 a.m.-10 p.m., Saturday: 8:30 a.m.-6 p.m.
62. Date(s) of Rental at Weaver Street Recreation Center*
    All rental requests must be made at least 30 days in advance.
64. Which room(s) do you want to rent at Weaver Street Recreation Center?

    1. Indoor Basketball Court (Capacity: 270, Features a Versa Court playing surface with two regulation height goals)
    2. Resource Center (Capacity: 35, Equipped with 10 computers)
    3. Game Lounge (Capacity: 65, Includes use of two cable ready televisions with gaming systems, air hockey and pool table)
    4. Multipurpose Room (Capacity: 35, Serves as a single meeting room, classroom, and/or open space for youth dance classes)
66. Expected Attendance*
68. Event Start & End Time*
    Event Start & End Time Start Time

    —

    Event Start & End Time End Time
    Rental reservations for Weaver Street Recreation Center are available Monday-Friday: 1 p.m.-9 p.m., Saturday: 1 p.m.-6 p.m., Sunday: Closed.
70. Date(s) of Rental at I.R. Holmes, Sr. Recreation Center at Campus Hills*
    All rental requests must be made at least 30 days in advance.
72. Which room(s) do you want to rent at I.R. Holmes, Sr. Recreation Center at Campus Hills?

    1. Gymnasium (Capacity: 400, Includes use of bleachers and scoreboard)
    2. Multipurpose Room (Capacity: 100, Includes use of kitchen space)
    3. Dance Room (Capacity: 30)
    4. Picnic Shelter (Available Monday - Thursday)
74. Expected Attendance*
76. Event Start & End Time*
    Event Start & End Time Start Time

    —

    Event Start & End Time End Time
    Rental reservations for I.R. Holmes, Sr. Recreation Center at Campus Hills are available Monday-Thursday: 6 a.m.-9 p.m., Friday: 6 a.m.-8 p.m., Saturday: 8 a.m.-6 p.m., Sunday: 1 p.m.-6 p.m.
78. Set-up Time*
    Set-up Time
    What time do you need to enter the facility in order to set up by the start of your event?
79. Clean Up End Time*
    Clean Up End Time
    What time will you be finished cleaning up and exiting the facility? Must clean up by the end of operating hours.
81. Will you be purchasing Setup/Breakdown from Durham Parks and Recreation?

    1. Yes
    2. No
83. Who will be attending?*
    -- Select One --Invited Guests OnlyTicketed AudienceFree to the PublicOpen to the Public with Paid AdmissionOpen to the Public with Recommended Donation
85. What is the average age of the attendees?*
    -- Select One --YouthYouth / Teens (10-15)Teens / Young Adults (16-25)AdultsFamily / All Ages
87. Will fees or donations be collected?*
    -- Select One --No Fees or Donations Will Be CollectedIn Advance or Presale OnlyOnly at the DoorAt the Door and in AdvanceRecommended Donations at the Door
89. How will you be advertising your event?*
91. Will you be serving food?*

    1. Yes
    2. No
93. Event Details
Leave This Blank:


95. 1. Receive an email copy of this form.
96. Email address

    This field is not part of the form submission.

97. Submit

* indicates a required field