Facility Use Request Organization Name*Main Contact*Email* Day Phone Number*Evening Phone Number*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Event Dates (Range)*Time Requested*Event Start Time* : HH MM AM PM Event End Time* : HH MM AM PM Clean Up End Time* : HH MM AM PM Which area(s) are you requesting?* Court 1 Court 2 Court 3 Court 4 Multi-Purpose Room Detailed Instructions/Notes/Special Requests*Please allow a minimum of two weeks for your request to be processed. The annual $20 Permit Fee will be billed on your first invoice. This permit fee is paid once per school year for each building and covers the fiscal year July 1 to June 30.* I agree to have all individuals using the Hope Fieldhouse facilities I reserve complete the Hope Fieldhouse Guest Waiver prior to use of the Hope Fieldhouse facilities.*Please Initial** I will indemnify and hold harmless Hope Fieldhouse and its directors, officers, employees, representatives, and agents from and against any and all loss, claim, injury damage, illness or liability (except for injuries caused by the gross negligence of Hope Fieldhouse or its employees) caused, sustained or incurred by any individuals using the Hope Fieldhouse facilities I reserve.*Please Initial*Printed Name*Date* MM DD YYYY By my signature, I acknowledge that I have read, understand, and agree to the policies and procedures of the Facility Rental Handbook found on the Hope Fieldhouse Website.*NameThis field is for validation purposes and should be left unchanged. Start YourMembership Today Join Now Contact 2645 145th Street W Rosemount, MN 55068 (612) 474-4600 email@example.com Hours Daily5am - 10pm Holiday Hours FollowFollow Hope Fieldhouse is a certified 501(c)(3) organization.