County of Brant Banquet Hall and Room Request

Name (First and Last)

Organization/Department

Address (Street address, P.O. Box, R.R. #, Apt/Suite)

City

Postal Code

Phone Number (s)

Email

Please provide date of event/function

Start time of event/function:

End time of event/function

Type of Event/Function

Expected Attendance

Is the event for youth ages 13-17?

Yes

No

Will alcohol be served at your function? (additional documentation will be required)

Yes

No

Pick facility you would like to book:

Airport Community Centre

Brant Sports Complex

Burford Community Centre

Scotland Community Centre

South Dumfries Community Centre

Syl Apps Community Centre

Liability insurance is mandatory for all rentals at County of Brant facilities at an additional cost. Please let us know which insurance you would like to purchase.

Yes, $2 million

Yes, $5 million

No, will provide own certificate of insurance

Please provide any additional information about your event/function

Please provide your signature

Clear

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County of Brant Banquet Hall and Room Request