You must have JavaScript enabled to use this form. Current Contact Facility Your Event Alcohol Insurance Submit Complete Name Thank-you for your interest in booking one of our community centres or park pavilions. Note: This form works best on a desk-top computer (phones and tablets may not work). If you need the form in a different format, please contact the Komoka Wellness Centre.Please to complete the following form all the way through to the "Submit" button.A member of Middlesex Centre's Community Services Team will get back to you about your inquiry within a few business days. First Name Last Name Telephone Email Address Do you live in Middlesex Centre? Proof of residency may be requested. Yes No Address Address Town Province Postal Code Are you booking for personal use or on behalf of an organization? Personal Organzation Name of Organization Do you have booking authority for the organization? Yes No
