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Community Center Reservation Form

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Steps

1. Step One This section is complete This section is incomplete
2. Group Information This section is complete This section is incomplete

Step One

Please complete the following information.
This form is to request dates for use of the Huber Heights Community Center. Only nonprofit organizations are able to use this building space. Once dates are confirmed by City Staff, you will be emailed the user agreement for completion and a link to submit payment.
Contact Information
Contact Name:*
Organization Name:
Address:*
City:*
State:
Zip:*
Phone Number:*
Email Address:*
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Group Information

Number of Persons in Group*
Additional Needs:
1. Tables
2. Chairs
Reservation Date(s) / Time(s):*
Please list all dates and times requested for use of the space.
Please select one of the rooms:*
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
1. I agree.
Electronic Signature

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6131 Taylorsville Road
Huber Heights, OH 45424

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