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First Name*:

Last Name*:

Phone*:

Email*:

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Physical Address 1:

Physical Address 2:

Physical City:

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Name of Organization*:

Name of Event*:

Previous Location of Most Recent Event*:

Event Budget*:

$

Arrival Date*:

Departure Date*:

Are these dates flexible?

Would you require a room block?

If so, how many rooms are needed?*:

Number of Guests Per Night*:

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Sports Facilities