2. The Cowichan Community Centre can provide venues for meetings, events, birthday parties, fitness, sport and dance. Please complete the form and submit by email, or print and deliver to 2687 James Street, Facility Booking (2nd floor)
4. Contact Information
6. Full Name:*
8. Email Address:*
10. Title:
12. Organization Name:
14. Address:*
16. City:*
18. Province:*
20. Postal Code:*
22. Telephone Number:*
24. Fax Number:
26. Have you booked with the Cowichan Community Centre before?*

    1. Yes
    2. No
28. Booking Information
30. Type of Organization*
    -- Select One --Not for Profit (reg. number required)Non-CommercialCommercialPublic (school, health, civic)
32. Type of booking*
    -- Select One --MeetingEventBirthday PartySportDanceFitnessPark
34. Expected Attendance*
    -- Select One --10-1515-3030-4545-6060+100+250+500+
36. Date(s) Required*
38. Times Required:
    Set Up: 15 minutes provided
    Clean Up: 15 minutes provided*
40. Bookings required*
    -- Select One --One time onlyDailyWeeklyMonthlyAnnualOther (short term/ongoing)
42. Select type of venue*
    -- Select One --ArenaDance StudioGymnasiumHallKitchenMeeting RoomBright Angel parkGlenora Trail Head park
44. Describe Any Equipment Requirements You May Need
46. Additional Comments/Questions
Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit Submit and Print

* indicates a required field