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2. Name*
3. Email Address*
5. Address*
7. City*
8. State*
9. Zip Code*
11. Phone Number*
13. Requirements for Full Facility Rental

    Rental Fees with Indoor Pool:
    3-hour facility rental/3-hour indoor pool rental: $365.00
    3-hour facility rental/2-hour indoor pool rental: $325.00

    Rental Fees without Indoor Pool:
    3-hour facility rental/No indoor pool rental: $250.00

    $100.00 deposit required and will apply to final balance.

    Rental request forms must be completed and deposit received (4) weeks prior to rental date. ERC requires (10) days to confirm rental request. Signed contract and payment in full is due two weeks prior to rental date. All cancellations within two weeks of your rental date will result in loss of deposit. Rental is only available after-hours and will be based on facility and staff availability. ERC programs have first priority. All rental rules apply. Alcoholic beverages are not allowed.

    Capacity: Limits will apply on a case-by-case basis

    The Emporia Recreation Center will provide (2) staff members for your event. (Does not include pool staff.) Staff responsibilities are as follows:
    1. Will open the building for event
    2. Will set up gym as specified in contract
    3. Will do hourly walk-throughs of the building
    4. Will check restrooms for toilet paper and paper towels (and locker room if pool included)
    5. Will provide cleaning supplies for any clean-up needed
    6. Will shut down building after event

15. Requested Date of Event - Option 1:*
    Requested Date of Event - Option 1:

    Include your first date choice for rental here. Date must be at least (4) weeks out for rental. Deposit is due (4) weeks prior to event.

16. Requested Date of Event - Option 2:
    Requested Date of Event - Option 2:

    Include your second date choice for rental here. Date must be at least (4) weeks out for rental. Deposit is due (4) weeks prior to event.

18. Requested Arrival Time:*
    Requested Arrival Time:
19. Requested Departure Time: *
    Requested Departure Time:

    Must be a minimum of (3) hours.

21. Estimated # of Attendees:

    This is just to give us an idea on capacity for the facility.

23. How many chaperones will you have?*

    Must have 1:15 ratio

24. Chaperone Requirement*

    The Emporia Recreation Center requires chaperones for parties including minors.  The required ratio is 1:15.  Our staff is only present to manage our facility.  They are not available to regulate minors in any capacity.

    1. I have read the above requirements and agree to provide chaperones in a 1:15 ratio if required for my rental.
26. What areas do you need for your rental?*

    Let us know what areas you plan to use so we can plan for staff.  Please note that the conference room and the Wellness Center are not available for rent.  The Walking Track is only available for adult chaperones to use to see the gym as needed. 

    1. Gymnasium
    2. Racquetball Room
    3. Upstairs Studio
    4. Indoor Pool
    5. Community Room

28. The Emporia Recreation Center will contact you within (10) days from receiving this request to confirm.

Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

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