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Winter Wise
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Picnic Rental Request Form
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Steps
1.
Step One
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2.
Requested Dates, Time, & Locations
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3.
Event Details
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4.
Contact Information
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Step One
Please complete all required fields (marked with an asterisk) before submitting the form. If the submission is not sent please review your submission and complete the missing fields. You will receive a confirmation once you have successfully submitted the form.
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Requested Dates, Time, & Locations
1st Choice Date
*
1st Choice Date
2nd Date Choice
*
2nd Date Choice
3rd Choice Date
*
3rd Choice Date
Event Start & End Times
*
Event Start & End Times Start Time
—
Event Start & End Times End Time
1st Picnic Shelter Selection
*
-- Select One --
Blue Mountain Park (500 person capacity)
Mundy Park (100 person capacity)
2nd Picnic Shelter Selection
*
-- Select One --
Blue Mountain Park (500 person capacity)
Mundy Park (100 person capacity)
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Event Details
Number of People Attending
*
Is this event open to the general public?
*
Yes
No
Is a ball diamond required?
*
Yes
No
Is a sports field required?
*
Yes
No
What activities will be part of your event?
*
(e.g. bouncy castles)
Will this event be catered?
*
Yes
No
Will there be an event planner?
*
Yes
No
If you are planning to use tents, please indicate the quantity and size of each tent.
*
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Contact Information
Group Name
*
Contact Name
*
Mailing Address
City
Province
Postal Code
Email
*
Phone
*
Cell Phone
Fax
Comments
Privacy Agreement
*
By checking "I consent" you are consenting to the voluntarily collection and use of your personal information in accordance with Section 26(d) of the Freedom of Information and Protection of Privacy Act. The information provided by you will be used solely for the purpose of requesting a picnic. Your information will not be used for any other purpose. If you have any questions about the collection, storage, correction and/or use of your personal information please contact Claudette Haire, City of Coquitlam, Parks, Recreation and Culture at 604-927-3534.
I consent
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