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2. *** PLEASE READ THIS FIRST ***

   If you are planning to submit this form to request rental of the NCH Community Senior Center, please REVIEW our current Rental Policy & Fees BEFORE submitting this form. If this link is broken, please navigate to Services > Facility Reservations on our website for more information.

4. REQUESTOR INFORMATION
6. First Name*
7. Last Name*
9. Email Address*
10. Best Phone Number*
12. Address*
13. Apt/Suite/Floor
15. City*
16. State*
17. Zip*
19. Organization Name (Optional)
23. EVENT INFORMATION
25. Facility Requested*
    -- Select One --Dumele ParkPies ParkSchaeper ParkStapleton ParkVeterans ParkWise ParkNCH Community Senior Center (Rental Agreement & Fees REQUIRED)

    NOTE: The NCH Community Senior Center REQUIRES three weeks (21 days) advanced notice in order to rent, and is NOT available to rent on major holidays.

27. Capacity Acknowledgement

    Please check this box to acknowledge that the community room at the NCH Community Senior Center has a capacity of 150 seated persons - HOWEVER - the NCH Community Senior Center community room currently only has tables & chairs to seat approximately 80 guests. If your event will be attended by more than 80 guests, you will need to bring in additional tables & chairs.

    1. CAPACITY ACKNOWLEDGED
29. Estimated Attendance*
31. Event Date*
    Event Date

    IMPORTANT! The NCH Senior Center Community Room requires at least three weeks (21 days) advanced notice from today, to allow time for internal review of your request by the Mayor, and - if approved - to get the rental agreement signed, invoice issued & fees paid, etc.

32. Alternate Date [Optional]
    Alternate Date [Optional]

    If your date is flexible, please suggest an alternate date. If your date is firm, please leave this blank.

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

    —

    Event Start & End Time End Time
36. Event Frequency*

    1. Single Date
    2. Series of Dates
37. Number in Series
39. Event Description*

    Please describe your event, including whether you will have any 3rd party services such as food trucks, port-o-lets, DJ, etc.

41. Event Type*
    -- Select One --Private Social EventCorporate Event/MeetingCommunity Service ActivityPublic Program, Class or ActivityOther (Please Explain)
42. Event Other
44. Attendee Type*
    -- Select One --General Public - FreeInvitation Only / Friends / FamilyTicketed / Entry FeeEmployees / Customers / ClientsVolunteersOther (Please Explain)
45. Attendee Type Other
47. ACKNOWLEDGEMENTS*

    By checking the box below, Applicant acknowledges the following:

    • This form is only to request a City Park or Facility. It does not confirm your reservation.
    • A city employee will reach out to gather more information and determine if the reservation can be confirmed.
    • Additional paperwork, deposits &/or rental fees may be required.
    • Failure to return all required items by the due dates may result in cancellation of your reservation.

    1. ACKNOWLEDGED
Leave This Blank:


49. 1. Receive an email copy of this form.
50. Email address

    This field is not part of the form submission.

51. Submit Submit and Print

* indicates a required field