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Facility Rental Application

2. FACILITY REQUEST APPLICATION
   Please select from the following facility's in which you are inquiring.

   Please select from the following facility's in which you are inquiring.

4. Wackford Community Aquatic Complex

   1. Valley Oak Ballroom
   2. Teen Center
   3. Poppy Room
   4. Willow Room

5. Elk Grove Park

   1. Pavilion
   2. Strauss Island

6. Laguna Town Hall

   1. Reception Hall
   2. Courtyard

8. APPLICANT CONTACT INFORMATION
   Name and DOB of individual responsible for event

   Name and DOB of individual responsible for event

10. First Name*

11. Last Name*

12. DOB

    Must be 18 to apply

14. Application on behalf of:*
    -- Select One --Individual Non-ProfitOrganizationBusiness

15. Name of Non-Profit, Organization or Business

17. Address*

19. City*

20. State*

21. Zip Code*

23. Phone Number*

24. Email Address*

26. ALTERNATE CONTACT

28. Name*

29. Email Address

31. Phone Number*

35. RENTAL INFORMATION

37. Type of Activity/Event:*

38. Approximate Attendance:*

40. Rental Date:*
    Rental Date:

41. Start Time*
    Start Time

    Rental times must include set-up and clean-up

42. End Time*
    End Time

    Rental times must include set-up and clean-up

44. TELL US MORE ABOUT YOUR EVENT:

46. Will Alcohol be served?*
    -- Select One --YesNo

    **Not allowed for any events that are honoring a minor**

47. Will Alcohol be sold?*
    -- Select One --YesNo

49. Will Food be served?*
    -- Select One --YesNoUnknown

50. Type of amplified Sound*
    -- Select One --In house Sound System (fee $50)DJBandSpeeches/AnnouncementsKaraokeOther

52. Are you requesting a Non-profit Rate?*
    -- Select One --YesNo

53. Will there be an admission fee?*
    -- Select One --YesNo

    **All admission fees need to be pre-collected/sold**

57. APPLICATION SIGNATURE
    Counterparts. This Agreement may be executed in two or more counterparts, each of which will be deemed an original but all of which together will constitute one and the same instrument. I understand that I will be contacted by a CSD representative within three business days from the date the application is submitted and that my application for the use of the facility is not final until a contract is signed and a payment is made. I attest that all the information provided in this application is true and correct.

    Counterparts. This Agreement may be executed in two or more counterparts, each of which will be deemed an original but all of which together will constitute one and the same instrument. I understand that I will be contacted by a CSD representative within three business days from the date the application is submitted and that my application for the use of the facility is not final until a contract is signed and a payment is made. I attest that all the information provided in this application is true and correct.

59. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
61. Electronic Signature*

63. Date/Time of Submission *
    Date/Time of Submission

    Date/Time of Submission

64. How did you hear about our facility?*
    -- Select One --Social mediaActivity GuideFlyer/posterReferralGoogleOther

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 Submit and Print

* indicates a required field