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2. Single Use Pavilion Request Form
4. Name (First and Last)*
5. Email Address*
7. Address*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
17. Type of Event or Activity *

    i.e. Group meeting, birthday party, team registration, etc. 

19. What equipment, if any, will you be using during your event/activity?*

    Please list all items you plan to bring with you or use on this day. 

21. Anticipated Attendance*
23. Requested Pavilion *

    1. Barnard Park
    2. Roy Park
24. Is this a fundraising event?*

    1. Yes
    2. No
25. Will fees be charged for the event?*

    1. Yes
    2. No
27. Is this for a group or organization?*

    1. Yes
    2. No
28. If yes, please name the organization.
30. Date and Time being Requested*
    Date and Time being Requested Start Date

    Date and Time being Requested Start Time

    —

    Date and Time being Requested End Date

    Date and Time being Requested End Time
32. Alternate Date and Time
    Alternate Date and Time Start Date

    Alternate Date and Time Start Time

    —

    Alternate Date and Time End Date

    Alternate Date and Time End Time

    Adding an alternate date is not required but will reserve the pavilion for a second date in the event of bad weather or unscheduled cancellation. If no alternate date is added we cannot guarantee that, you will be able to secure another date if an unplanned cancellation occurs.

36. By signing your name below, you agree that you read and understand all the terms spelt out in the policy and agree to follow all rules and regulations.

38. Signature*
39. Date:*
    Date:
43. Approval or Denial

    Section below is to be filled out by Parks and Rec Staff only. 

45. Request Approved or Denied

    1. Approved

    1. Denied
46. If no, reasoning:
48. Name:
49. Title:
51. Signature:
52. Date:
Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field