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Canyon Community Center Rental Request Form

  1. Rental Request Form

    Canyon Community Center
    P.O. Box 187
    126 Lion Boulevard
    Springdale, UT 84767

    Phone: 435-772-3434
    Fax: 435-772-3952

    Do not submit fees/deposits with this form. Use the Rental Policy to fill out the following.

  2. User Information

  3. Classification of User

    Check one.

  4. Group 1

  5. Group 2

  6. Group 3

    (Attach copy of 501(c)3 determination letter with this form.)

  7. Group 4

  8. *Attach with this form proper verification to receive the local rate. See definition of a local in Rental Policy.

  9. Room Rental & Use

    Check applicable boxes.

  10. Rooms

    *Gallery floor available only with rental of 3-part auditorium.

  11. Additional Equipment

  12. Description of Event

  13. Example: meeting, wedding, etc.

  14. Estimated Attendance:

    1 adult per 10 youth attendees required.

  15. Please check the following that apply to the event:*

  16. If alcohol will be served, DABC Single Event Permit and additional insurance may be required. See Alcohol Permits and Insurance in Rental Policy.

  17. Example

    A four-hour event on the 8th of December 2007 starts at 5pm. The caterers need to arrive an hour early and general clean-up requires ½ an hour. The entire event rental will be for 5 ½ hours and renter will be charged for an 8 hour period.

    The information required should be entered below as:
    Date(s) mm/dd/yy
    4 - 5 p.m.
    5 - 9 p.m.
    9 - 9:30 p.m.
    Total Hours
    5.5 hours

  18. Single Event 1st Choice

    Use additional columns for multiple day events.

  19. Single Event Alternative

    Use additional columns for multiple day events.

  20. Re-Occurring Use 1st Choice

  21. Weekly

  22. Monthly

  23. Day

  24. Time of Use:

  25. Re-Occurring Use Alternative

  26. Weekly

  27. Monthly

  28. Day

  29. Time of Use:

  30. Submitting this form does not constitute a contract. Canyon Community Center will contact you within five working days regarding your request. Pricing and/or conditions subject to change without notice.

    The undersigned, hereby agrees to be responsible for any damages to the facility occurring during and by this use, and agrees to be responsible for the conduct of all persons attending this function. Applicant further agrees to be responsible for any accident or injury occurring to anyone during and by this use, and agree that the Town of Springdale, its officers and employees, shall not be responsible for any such injury of loss, except as arises from the sole willful act, omission or sole negligence of the Town of Springdale, its officers or employees. The undersigned has received a copy of the Facility Use Policy and agrees to comply with the rules and regulations listed therein.

  31. Leave This Blank:

  32. This field is not part of the form submission.