Rental Request Form: Village of Pemberton

Rental Request Form - Pemberton and District Community Centre

Event Details

Name/Type of event:

Name of organization:

Purpose of rental:

Is the event open to the Public:

Yes

Are you charging admission:

Yes

Security required:

Yes

Expected # of participants:

Type of organization

Commercial or Private Business

Local Resident

Government

Non-profit / Charity group

Non-profit or Charity #:

Contact Information

Mailing Address:

City

Postal Code

Primary contact

Phone

Secondary Phone

Alternate Contact

Email:

Phone

Secondary Phone

Requirements

Insurance is mandatory for all events:

You may purchase from the Pemberton and District Community Centre at the time of rental or bring a certificate of insurance from your insurance provider showing that Squamish-Lillooet Regional District and Village of Pemberton is additionally insured on your policy for a minimum $5 million liability.

Music

Yes

Food

Yes

Alcohol

Yes

Room Requested

Rooms

Activity Room

Great Hall

Youth & Senior Centre

Kitchen

Date(s) requested

Day(s) of the week

Start time and End time

Leave Blank

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Municipal Services

Rental Request Form - Pemberton and District Community Centre

Event Details

Contact Information

Requirements

Insurance is mandatory for all events:

Room Requested

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