Ezra Conference Center

Please provide the following contact/event information:

First name
Last name
Phone Number
Email
Individual/Organization
Type of Event
Days of Event	to
Reserve Time	to
Duration of Event
Space Needed
Food Served	Yes No
Use House Caterer Rental Deposit Security Deposit	Yes No NOTE: If house caterer is not used a service fee of $2.00 per attendee will be charged. To secure your event date a deposit of 50% of the rental cost is due upon signing the Rental Agreement. A security deposit equal to one hourly rate is required in addition to the rental deposit upon signing the rental agreement. This deposit is* refundable.
Additional Equipment Rental:	Enter your equipment needs here.

Note: This form will be used to quickly identify your needs and to prepare the event agreement.

Special Event/Reservation Form