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We Love to Uplift | WLTU | Haiti | Chicago, IL
Create Opportunities For Success
Rental Request Form
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Please enable JavaScript in your browser to complete this form.
LESSEE INFORMATION
Name
*
Address:
*
Telephone Number:
*
Email
*
Legal Entity EIN/Last Four Digits of Individual's SSN
*
Name and Title of Authorized Signatory
(If Lessee is a Legal Entity)
Event Information
Event Location:
*
13838 S. Croissant Drive, Burnham, Illnois 60633
13900-13926 S. Croissant Drive, Burnham, Illinois 60633
13926 S. Croissant Drive, Burnham, Illinois 60633
Start Date / Time of The Event
*
Date
Time
End Date / Time of the event
*
Date
Time
Number of Guests
*
Purpose of the Event
*
Check all that apply
Music Playing/DJ
Live Band/Singer
Type of Live Music
(if applicable)
ADDITIONAL SERVICES
Will the Event require any of the following services
Sound/AV Equipment
Cleaning Support
Third Party Vendor
Check all that apply
If a Third Party Vendor is required, please list
(i.e: Security)
INSURANCE INFORMATION
Lessor’s Renter’s Insurance Application Form Required
*
Yes
No
Age Group of Guests/Attendees
*
Minors (17 or younger)
18 – 24
25 – 35
35+
Check all that apply
*
Water Activities
Amusement Devices/Inflatables
Rides
Camping/Sleeping Overnight
Have you or anyone involved in the Event had more than 1 Event Liability Claims/Losses or any Event Liability Claim/loss valued over $10,000 in the past 5 years?
*
Yes
No
Please provide details if you said yes to the Event Liability Claim above
*
Submit
Rental Policy
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