Climbing Wall Rental Request Climbing Wall Rental Campus Recreation Affiliation * RequiredUIC StudentUIC Campus Recreation MemberNon - MemberName of GroupContact Person * RequiredStreet Address * RequiredCity and Zip Code * RequiredPhone * RequiredEmail * Required Number of Participants * RequiredDid you want to rent any other space within our facility? * RequiredNoYesWhat additional space would you like to rent? * Required Party Room / MAC Suite Swimming Pool MAC Gym Basketball Court(s) Meeting Space (Room 224,226) Preferred Date 1 - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY Preferred Start Time 1 * Required : HH MM AM/PM AM PM Preferred End Time 1 * Required : HH MM AM/PM AM PM Preferred Date 2 - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY Preferred Start Time 2 : HH MM AM/PM AM PM Preferred End Time 2 : HH MM AM/PM AM PM Additional Comments of Concerns This iframe contains the logic required to handle Ajax powered Gravity Forms.