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2. Company Name
4. If Non-Profit Organization, must provide 501-C3 form
6. First Name*
7. Last Name*
9. Address1*
11. Address2
13. City*
14. State*
15. Zip*
17. Phone #*
18. Other Phone #
20. Email address
24. Date of Event*
26. Event Description*
28. Pavilion Rental?
    -- Select One --YesNo
30. Park Choice

    1. JD Redd Park
    2. James Archer Smith Park
    3. Harris Field
    4. Mistretta Park
    5. Myr. Roscoe Warren Park
31. Pavilion Number (Myr. Roscoe Warren Park)
    -- Select One --1234567
33. Set-up Time
34. Clean-up Time
36. Will you be having a bounce-house?
    -- Select One --YesNo
37. *Bounce-houses require general liability insurance
39. Expected number of people
40. Will alcohol be served/sold?
    -- Select One --YesNo
42. *Alcohol is only allowed at Harris Field & Losner Park. Liquor liability and/or liquor permit is needed if alcohol is being sold/served*
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43. Print Only

* indicates a required field