Facility Rental Request Form

Type of Event

Date Required

Alternate Date (If Original Date is Unavailable)

Entry Time

Exit Time

If "Other" selected, please specify here:

Will your event have music/live music being played?

Yes

No

Liquor License Obtained (if required)

Yes

No

Not Required

Will Your Event Require a Lottery License?

Yes

No

Unsure

Preferred Method of Contact

Mail

Email

Phone

Name

Address

Email

Phone Number

Acknowledgement and Approval:

I have read the Township of Southgate Facility Rental Policy # 30 and further, I agree to accept these policy terms and conditions as part of this rental agreement. Failure to abide by any clause of this rental agreement could result in loss of future rental rights, agreements and all facility deposit and booking fees previously paid to the Township.

Signautre

Clear

Date

Forms

Facility Rental Request Form