Lichen Hollow Rental Application

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Please provide the following information

Contact Name *
Contact Name
Contact Address *
Contact Address
Daytime Phone *
Daytime Phone
Cellular *
Registered 501 (C) Non-Profit? *
Use Description
Requested Date *
Requested Date
Requested Time (From) *
Requested Time (From)
Requested Time (To) *
Requested Time (To)
Please select all that apply
Please describe in detail how you/ your organization will be using LIchen Hollow. Please include details about Kitchen use, outdoor grounds use and indoor meeting hall use.
Will alcohol be available?
Is there a charge for the alcohol? Will there be designated bartenders? If not applicable, please type N/A
Will you be serving food?
A copy of the caterer's business license and insurance will be required. ***LICHEN HOLLOW'S KITCHEN IS NOT CERTIFIED*** No food may be prepared in the kitchen, but it may be staged from the kitchen. If the food is provided by individuals, food handler's permits will be required by all kitchen help. If you are not serving food type N/A