Will Your Event Have Food:
Will It Be Catered:
Who Will Cater:
Will Your Event Have a DJ/Band:
Who Will It Be:
Will Alcohol Be Served at Your Event:
Beer/Wine/Champagne:
Spirituous Liquor:
Permit #:
Name(s) and Telephone Number(s) of Chaperone(s) if applicable:
Any Other Special Needs or Request:
Print Name:
Sign and Date:
I hereby certify that I am the authorized and responsible representative of the petitioning group. The above statements are true to the
best of my knowledge. I have read a copy of the policies governing the use of the facility, and agree that our group will comply with the
rules
and regulations, policies and fee schedule governing the use of the facility. I also agree that all rent and fees shall be paid by the
above due date (14 days before the scheduled event) or confirmed reservation shall become void. I understand that all charges and fees
will be reviewed with me once your reservation is entered; these will also be detailed in my Reservation Permit/Confirmation. I should
not consider my reservation confirmed until I receive my confirmation number.
THE USE OF ANY TOBACCO PRODUCT IS STRICTLY PROHIBITED.
Limited Special Occasion Permit is Required to serve spirituous liquors (ABC Commission, Raleigh, NC)
You will need to obtain this permit application from the City of Kannapolis, as staff has to sign the application before it is submitted to Raleigh.
Please complete the information requested above and return to
Elizabeth Cox at the information listed at the top of the form.
