Please fill out the following form, if you would like to request a reservation
We do not guarantee the requested date, it is subject to availability.

First Name:

Last Name:

Organization:

Mailing Address:

City:

Zip:

State:

Primary Phone Number:

Email Address:

Are you a HWC member?

Yes

No

Member ID:

Event Info

Event Frequency:

Single day

Multiple days

Event Name/Type (birthday, sport etc.):

Starting date:

Ending date:

Alternative Starting date:

Alternative Ending date:

Starting time:

Ending time:

Additional Information

Fundraising Event:

Yes

No

Facility/Space Requested:

Special Needs/Set up/Equipment:

Food service:

If yes, please contact Cranmer Dining center at: (270)384-8125

Yes

No

Age range of target audience:

0-5 yrs

6-10 yrs

11-15 yrs

15 yrs or older

Number of attendees:

0-10

11-20

21-30

30 or more

You will be charged a $25 fee.
After submitting this form, you can complete the transaction on the next page.

Your deposit will be refunded if the Holloway Health and Wellness Center is unable to accommodate your reservation