This form is for information only and does not guarantee your event will be held at The Sanctuary until a permit agreement is executed.

Rev. Dr. Mr. Mrs. Ms.

First Name
Last Name
Address
City
State
Zip
Home Telephone
Cell Telephone
Work Telephone
Email Address
Date of Event
Second choice if no availability for preferred date:
Time of Event		Begin:End
Type of Event
Total Guests
		Choose One Adults Only Teen Event Majority Children Combination Adults and Children
Will event include food and beverage?		Choose One Yes No
Beverages Only		Choose One Yes No