OTHER FACILITY SPACE REQUEST

Primary Contact Name *

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Primary Contact Phone Number *

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Primary Contact Email *

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Organization/Company Name *

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Preferred Rental Start Date(s)

Preferred Rental End Date(s)

Preferred Rental Start Time(s) *

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Preferred Rental End Time(s) *

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Facility Space *

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Please provide us with a description of your event. *

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Please provide any other information that would be helpful to assist our staff in preparing for your rental. *

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Phone: (518) 579-4000Address: 390 NY-Route 146 Halfmoon, NY 12065Email: guestservices@impactathleticsny.com