Welcome to the Picnic Shelter Reservation System

  First Name:

 *required

  Last Name:

 *required

  Mailing Address:

 *required

  Apartment # / Additional Address:

  City:

 *required

  State:

 *required

  Zipcode:

 *required

  Phone Number:

  (  ) 

 *required

  Alternate Phone Number (Work/Cell/Pager, etc):

  (  ) 

  Email Address:
  (Email Address is required in order to receive receipts and other notifications
  If you do not have a valid email address, please contact us at (757) 888-3333
  or toll-free at (800) 203-8322 and we will take your reservation over the phone).

 *required

  Credit Card Type:

   -- Pick One -- Master Card Visa American Express Discover Card <select type>  

 *required

  Credit Card Number (no dashes or spaces):

 *required

  Expiration Date:

  Month <xx> 01 02 03 04 05 06 07 08 09 10 11 12  Year  <xxxx>2025202620272028202920302031203220332034

 *required

  Card CVC code (on back of card):

 *required

  Name as it appears on the card:

 *required

  Billing Zipcode:

 *required