Contact Information

Renter name:*

Organization / company:

Address:*

City:*

State:*

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Zip:*

Phone:*

Alternate phone:

Fax:

Email:*

How did you hear about our rental program?*

Program Information

Please provide a brief description of your event:

Event date:*

Event time:*

Event duration:*

Number attending:*

Rental location:*

Additional hours needed:

Rental attendant needed:*

No Yes

Referred by:*

Additional set-up information (tables, chairs, tents, etc.):

Other Event Information

Food at event:*

No Yes

Caterer:

Caterer phone:

Liquor at event:*

No Yes

Liquor insurance:

N/A Provided by renter Provided by caterer

Other information / comments: