Please complete this form and click submit when done. Due to a large volume of interest, inquiries will be responded to in the order they were received, normally within 48 hours. Coppermine Fieldhouse thanks you for your patience while we process your requests.

Please click here to read our Rental Regulations

 

NAME OF PERSON IN CHARGE: (required)

NAME OF GROUP OR ORGANIZATION:

STREET ADDRESS:

CITY:

STATE:

ZIP:

PHONE: (required)

FAX NUMBER:

EMAIL ADDRESS: (required)

YOUR ORGANIZATION IS:

TAX EXEMPT NUMBER:

NAME OR TITLE OF YOUR PROGRAM: (required)

WEBSITE:

WHAT TYPE / NATURE OF EVENT WILL YOU BE HOSTING?:

ANTICIPATED ATTENDANCE:

WILL YOU SELL TICKETS?:

EXPLAIN REGARDING TICKETS:

WHAT SPACE WILL YOU BE USING:

DATE(S) AND TIME(S) YOU WOULD LIKE TO USE THE FACILITY:

QUANTITY OF TABLES NEED:

QUANTITY OF CHAIRS NEED:

Coppermine Fieldhouse/Duburns Arena is not responsible for set up of any rental. It is the responsibility of the renter to set up and break down all rooms available for rent.

WILL YOUR EVENT BE USING CATERING SERVICES:

NAME OF CATERER:

PHONE NUMBER OF CATERER:

WILL YOU NEED OR BE PROVIDING SECURITY FOR YOUR EVENT:

WILL YOU BE USING ANY DECORATIONS THAT NEED TO BE APPLIED TO THE WALLS, FLOORS AND/OR CEILING?:

EXPLAIN REGARDING DECORATIONS:

WILL YOU BE USING ANY DJ, LOUDSPEAKER, OR AUDIO EQUIPMENT DURING YOUR EVENT?:

EXPLAIN REGARDING AUDIO:

WILL YOU BE USING “COPPERMINE DUBURNS ARENA” NAME TO ADVERTISE OR PROMOTE YOUR EVENT?:

EXPLAIN REGARDING “COPPERMINE DUBURNS ARENA” NAME:

WILL YOU BE SELLING OR PROVIDING ANY ALCOHOLIC BEVERAGES?:

PRINT NAME AS SIGNATURE: (required)

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