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Introduction

Special Events Request Form Civic Center
Important: Please Read
- Resident Hourly Rate: $55(minimum 3hrs) | Non-Resident Hourly Rate: $75 (minimum 3hrs)
  Rental space is potentially available on Saturdays from 2:00pm – 10:00pm
  Rental space is potentially available on SUNDAYS from 1:00pm – 10:00pm
- DEPOSIT:
  There will be an additional $150 (cash) deposit to reserve the room and held as a cleaning deposit. The deposit is separate from the room rental fee. If the room and equipment are left in the same condition they were presented, the full deposit will be refunded the following business day after 10:00am.
- Requests for room rentals of the Civic Center must be made a minimum of 3 weeks prior to the event date.
Contact Information
Contact information for responsible adult
Photo ID is required with deposit and must match contact information.
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Contact Information

Last Name*
First Name*
Email*
Phone #*
Secondary Phone
Address*
City*
State*
Zip Code*
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Event Information

Date Requested
Facility Used For
Type of event (Birthday party, shower, etc..)
Time Requested( Free Hour)
We include 1 complimentary Free Hour
Time of Party/Event
Please include start and end time.
Approximate # of persons attending (Max 70)
Max is 70
Special Equipment Speaker- Free to Use
Special Equipment Microphone - Free to Use
Special Equipment TV - Free to Use
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Step Four

Cancellation Policy
CANCELLATION POLICY:
You must give at least 2 weeks notice to cancel your event. If you cancel after that time a $25 administrative fee will be deducted from the deposit. If you do not show for your event and no notice was given, you will forfeit your full deposit. The Civic Center is a municipality and must adhere to Federal and State of Emergencies. In the instance of a mandated state of emergency, or an act of god beyond the control of the Civic Center, a full refund of the deposit and payment will be returned if a mutually agreed upon date can’t be reached. However, no restitution will be given for prior costs incurred by the renter. (lost vendor deposits, wages, etc.)
AFFIDAVIT:
The person filling out this form agrees to comply with the policies and regulations of the Township of Bloomfield Recreation Commission for the use of the building and/or grounds of the Civic Center and agrees to be responsible for any negligence or damages:
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that
- your application will not be signed in the sense of a traditional paper document
- 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
- you may still be required to provide a traditional signature at a later date.
- No Loud DJ's
- No Bands
- No Smoking or Alcohol
- No Glitter or Confetti
1. I Agree
Electronic Signature

Leave This Blank:

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

This field is not part of the form submission.
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Civic Center Special Event Request Form

Steps

Introduction

Contact Information

Event Information

Step Four

Contact Us

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