Organization Name
Phone
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Booking Contact Name
Phone
Email
Billing Contact Name
Phone
Email
Emergency Contact Name
Phone
Email
Mailing Address
Street Address
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Date of Birth (Required for account creation for individuals, not organizations)
Facility Requested
Date Requested
MM slash DD slash YYYY
Time (please include setup/cleaning)
Expected number of attendees
Information about the rental.
Please specify the purpose of the rental
Please check all that apply
Will be serving alcohol
Will require use of the kitchen for cooking
Will only require use of the kitchen for coffee/tea/fridge, but will not be cooking
I am a caterer using the kitchen only
Will be playing music
Will be dancing
Please provide additional information about this rental (if the facility you're requesting has multiple rooms, please specify which room(s) you would like use of):
Insurance
Insurance is a requirement for all Norfolk County facility rentals. Please check the option you choose
Insurance — User Provided
I will provide proof of insurance that meets the county’s requirements below:
Minimum $2,000,000.00 Commercial General Liability
The Corporation of Norfolk County named as additional insured
Cross Liability
Host Liquor Liability (if serving alcohol)
Insurance — County
I would like a quote for the County’s Facility User Group Insurance
Payment
I would like to pay by:
Pay
Online
Cash
Cheque
Debit
Credit Card