Phone: 765.453.7455 | Located At: 5314 Flint Way, Kokomo IN 46902

Event Request Form

Your Info

First Name

Last Name

Company Name

Type of Event Requested
Phone Number

Email

Comments

Age Group
Elementary
Junior High
High School
Adult
Mixed (Adults and children of all ages)
Estimated Attendees

Event Info


Date

Start Time

AM
PM

End Time

AM
PM

Location

Alt. Location Address


City, State, Zip