Required fields are marked with asterisks (*)

Facility Rental Request Form

What facility would you like to book?

Type of Event

Date Required

Alternate Date (If Original Date is Unavailable)

Entry Time

Exit Time

Other Information/Amenities Requested

If "Other" selected, please specify here:

Will your event have music/live music being played?

Yes

Liquor License Obtained (if required)

Yes

Not Required

Will Your Event Require a Lottery License?

Yes

Unsure

Preferred Method of Contact

Mail

Phone

Name

Address

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.

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Date

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Facility Rental Request Form