City of Page | Facility Use Application

* Required field

Please fill out all required fields below:

Name of Organization:

Name of Applicant: *

Mobile Phone: *

Home/Work Phone:

Email Address: *

Page Utility Enterprises Proof of Utility Bill:

Mailing Address: *

City: *

State: *

ZIP: *

Physical Address: *

City: *

State: *

ZIP: *

Second Contact: *

Email Address: *

Mobile Phone: *

Home/Work Phone:

Facility Requested: *

Date of Event: *

Name of Event: *

Food and/or Drinks supplied: *

Commercially

Other

Rental Hours* * *Rental hours must include time needed for set up and cleanup.

Will alcohol be served? *

Yes

Estimated attendance: *

Describe event and activities, including any entertainment: *

By typing your name and pressing “Submit” below, you affirm that you have read, understand, and agree to all terms, conditions and rules in the Facility Use Request document, including the Hold Harmless Agreement. You further affirm and agree that you will require all participants to abide by the Facility Use Guidelines.

Please confirm your signature by typing your full name in the box below.

I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature.