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2. Personal Information
   Please complete the following information.
4. Full Name*
   First & Last Name
6. Date of Birth*
   Date of Birth
7. Gender*

   1. Male
   2. Female
9. Organization
10. Non-Profit (501c3)

    1. Yes
    2. No
12. Email*
14. Address*
15. Apartment #
17. City*
18. State*
19. Zip Code*
21. Home Phone*
22. Cell Phone
24. Rental Information
26. Event Type*
    What type of event are you having (ex. Wedding, Birthday Party, Reunion, etc.)?
27. Expected Attendance*
29. Date(s) of Rental*
31. Day of Contact Person*

    Name, Phone Number

33. 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?
34. Event Start & End Time*
    Event Start & End Time Start Time

    —

    Event Start & End Time End Time
    What time does your event begin and end?
35. Clean Up End Time*
    Clean Up End Time
    What time will you be finished cleaning up and exiting the facility?
37. Will you have amplified sound during your event?*

    1. Yes
    2. No
38. If yes, please indicate the start and end time of amplified sound.
    If yes, please indicate the start and end time of amplified sound. Start Time

    —

    If yes, please indicate the start and end time of amplified sound. End Time
40. Will you have an amusement ride or inflatable? *

    1. Yes
    2. No
41. If you answered yes to the previous question, list the rental company that will be supplying the ride or inflatable:
42. Will you have any tents?*

    1. Yes
    2. No
43. If you answered yes to the previous question, are the tents larger than 10x10'?

    1. Yes
    2. No
45. Will there be vendors selling goods other than food?*

    1. Yes
    2. No
46. Will you be selling food?*

    1. Yes
    2. No
47. Will you be setting up a building or stage?*

    1. Yes
    2. No
49. Will you be serving alcohol?*

    1. Yes
    2. No
50. What type of alcohol will you be serving?

    1. Beer and Unfortified Wine Only
    2. Beer, Wine and Liquor
    3. Fortified Wine/Liquor Only
51. How will alcohol be served?

    1. Sold by bartender/caterer
    2. Served by bartender/caterer
    3. Self service by guest
52. What time will you begin serving alcohol?
54. Please note:

    If you answered yes to any of the above questions, a special event permit will be required.

56. 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
58. What is the average age of the attendees?*
    -- Select One --YouthYouth / Teens (10-15)Teens / Young Adults (16-25)AdultsFamily / All Ages
60. 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
62. How will you be advertising your event?*
64. Event Details
Leave This Blank:


66. 1. Receive an email copy of this form.
67. Email address

    This field is not part of the form submission.

68. Submit

* indicates a required field