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c39d83fd-2822-43cf-b46c-9ab098b6488f
Textbox
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Name:
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*
selection is required
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098ee9e6-1d82-4745-8c30-220baa195be9
Textbox
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Address:
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*
selection is required
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52dcc02d-ec05-4326-8c74-9e55da537297
Textbox
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Phone Number 1:
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*
selection is required
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d117b064-2259-4ea6-91cd-5c16523547e5
Textbox
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Phone Number 2:
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437a73cc-9e82-444a-8a03-b7bed6964f17
Textbox
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Email:
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*
selection is required
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ac99ccc5-1f16-4cea-b2b9-c2a433431d12
Label
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The MPR closes promptly at 10:00 PM. Arriving prior to or staying after your reserved time is prohibited.
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b76c9503-4aab-4d72-89aa-97e9cf3026fa
Textbox
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Reservation Date:
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*
selection is required
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6c4b65fd-387f-4e96-b62d-86f59178cb1a
Textbox
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Start Time:
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*
selection is required
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137fe35e-95bd-451e-b03f-8cee7514ac5e
Dropdown List
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Start Time AM or PM:
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*
selection is required
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5f4515cf-a963-4dd8-a688-82209554c4ca
Textbox
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End Time:
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*
selection is required
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d1fb3eb0-aab4-4938-b3d1-9a68a9e2ea74
Dropdown List
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End Time AM or PM:
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*
selection is required
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3af5baef-7b47-40cf-84d4-2f330c957cb3
Label
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Rental rates are as follows:
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d36d4a28-4397-4898-a77e-957ee227ed70
Label
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Not for-profit costs (minimum time is 2 hours): 2 hours = $30, 3 hours = $60, 4 hours = $200, 5 hours = $300, each additional hour over 5 hours = $100
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9b57aff6-23e0-4061-91f8-452937dcb5e7
Label
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For-profit costs: $30 per hour, each additional hour over 3 hours = $110
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23924ab9-e953-44e7-984c-286b0cca66d9
Inline Text
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05d28bb9-fbc0-4f13-a93a-3954e73be3cc
Dropdown List
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Identify if the event is not for-profit or for-profit:
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*
selection is required
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40f87b75-bd34-4d74-ae35-95a63f5f1c0e
Dropdown List
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Event Type:
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*
selection is required
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c1e05409-091d-409b-b51d-1a054aa032cf
Textbox
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Event Details:
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59a02d3f-1a12-4d87-b368-f9acf4411a78
Inline Text
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For reservations using the pool, only 20 guests may be at the pool at any given time. There must be one adult chaperone in the pool area for every 3 guests under 18 years of age in the pool.)
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7a14ecbe-ae9a-4ac2-af5f-b5c6f971b532
Dropdown List
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Will the pool be used?
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*
selection is required
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438979ea-6c65-459b-b3b1-0271faa3761a
Inline Text
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Acknowledgement that you have read and accept the policies for use of the room (including financial responsibility for any additional charges/fines which may result from the event - see the MPR Policies for possible fines)
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42dac60e-38b1-4184-84d9-aa7049ea537b
Electronic Signature
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Signature:
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20f82797-79df-4974-aed1-a33fa1b0b005
Textbox
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Today's Date:
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*
selection is required
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d9468920-391c-4f73-9adf-befdac8f755f
Inline Text
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Once you submit this request, please review your completed copy for additional information regarding the review process and payment instructions.
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