Simcha/Event Reservation Request - Kemp Mill Synagogue

* Your Name

* Your Email Address

About Your Occasion

Occasion Type

Bar MitzvahBat MitzvahAufrufOther

Please specify occasion type

Name of Child

Name of Chatan

Reservation Type:
Selecting 'Minyan Reservation' will show you options about speaking, leining, and sponsoring kiddush

Room Rental ONLYMinyan Reservation ONLYRoom Rental + Minyan ReservationPlease include ALL rooms/minyanim/kiddush that you may end up using for your simcha. Adjustments can be made up until 6 months before the event, but anything that is not included on this form will not be held for your family and usage will be released for other events.

About Your Requested Minyan

Date of Requested Minyan

If 'Other' please specify here:

Will a family member be speaking at the Minyan? (Bar or Bat Mitzvah boy/girl only)

YesNo

Name of Speaker

About Your Requested Rental

*Click here to view the Room Rental Fees. Please note that food-related rentals may incur an additional Kitchen Usage Fee.

Room Usage #1

Date of 1st Room Usage

Enter Approximate Start Time:

Approximate number of people expected: (If you're not sure, check more than one)

Up to 35 people35-60 people60-160 peopleMore than 160 people

Do you need to enter information for a 2nd Room Usage time?

NoYes

Room Usage #2

Date of 2nd Room Usage

Enter Approximate Start Time:

Approximate number of people expected: (If you're not sure, check more than one)

Up to 35 people35-60 people60-160 peopleMore than 160 people

Do you need to enter information for a 3rd Room Usage time?

NoYes

Room Usage #3

Date of 3rd Room Usage

Enter Approximate Start Time:

Approximate number of people expected: (If you're not sure, check more than one)

Up to 35 people35-60 people60-160 peopleMore than 160 people

Do you need to enter information for a 4th Room Usage time?

NoYes

Room Usage #4

Date of 4th Room Usage

Enter Approximate Start Time:

Approximate number of people expected: (If you're not sure, check more than one)

Up to 35 people35-60 people60-160 peopleMore than 160 people

Do you need to enter information for a 5th Room Usage time?

NoYes

Room Usage #5

Date of 5th Room Usage

Enter Approximate Start Time:

Approximate number of people expected: (If you're not sure, check more than one)

Up to 35 people35-60 people60-160 peopleMore than 160 people

Additional Comments:
Please make sure you have entered all of your room usage information above before adding comments.
(Up to 5 Room Usage times for one occasion are allowed on this form)

Deposit & Agreement

Reservation Deposit

Deposit to secure date ($200)

Name of Event

The text entered in this field will appear next to the $200 reservation transaction on your KMS account. For example: "Moshe's Bar Mitzvah, 1/15/22"

* I agree to the following terms and conditions:

I agree to the following terms and conditions:Conditions of Reservation

Deposit: Your deposit of $200 must accompany this reservation form. The deposit will be credited against any room rental charges for this specific event. The date will NOT be held for you until this form and the deposit have been received by the office.
Payment: Six months prior to your simcha you will need to sign a facility usage contract with the shul office. At that time, a 50% non-refundable deposit must be paid to the shul (or a confirmed payment plan initiated). The balance of your usage charges is due (or a confirmed payment plan initiated) within two weeks following your simcha.
Non-Members: Reservations from non-members can only be accepted within 120 days of the requested date.

I/we hereby request the above noted date be reserved and enclose the non-refundable $200 deposit. Should the date not be available, I/we understand the KMS office will notify me/us to discuss other available dates. Additionally, I/we understand that we must contact the KMS office should we decide to cancel the date, once reserved, or wish to change the date.

Total Amount Due