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2. First Name*
3. Last Name
5. Email Address
   Email is preferred so we can give you alternatives and additional information.
6. Phone Number*
8. Address
10. City
11. State
12. Zip Code
14. SELECT A FACILITY

    Below are the 3 facilities available for event rentals. There are different rooms that can accommodate 20-400 persons. Please select your 1st, 2nd or 3rd choice. If you only wish to have your event at one location, then just fill in "1st choice" for that facility.

16. Centre Concord (max 400)
    -- Select One --1st choice2nd choice3rd choice
17. Willow Pass Community Center (max 200)
    -- Select One --1st choice2nd choice3rd choice
18. Senior Center (max 200)
    -- Select One --1st choice2nd choice3rd choice
20. How many persons/guests?*
21. What type of event is it?*
    -- Select One --Youth Event (Honoring person under 21))Meeting/SeminarWedding/ReceptionAdult Event (Honoring person 21+)BaptismBaby ShowerMemorial ServiceOther
22. What date(s) are you looking for?*

    Please provide 3 different dates and/or day & Month (Ex. Any Saturday in May).

24. What is the start time and end time of your rental?*

    Rental time must include setup and cleanup time. 

25. Will alcohol be present at your event?*

    1. Yes
    2. No
    3. I don't know.

    $85 fee for an Alcohol Use Permit and security will be required. Alcohol is not allowed at youth events.

26. How will you insure this event?*

    1. I will provide my own.
    2. I will purchase from the city.
    3. I don't know.

    Liability Insurance is required for all events.

Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field