Form Center

2. CITY HALL IS A SMOKE-FREE BUILDING
7. Name of Organization*
8. Purpose of Organization*
10. Designated Responsible Member*
11. Address1*
13. City*
14. State*
15. Zip*
17. Daytime Phone*
18. Email Address*
22. Nature of meeting*
24. Date and Time Requested
    Date and Time Requested

    Date and Time Requested
25. Additional Date and Time Requested
    Additional Date and Time Requested

    Additional Date and Time Requested
27. Approximate size of group*
28. Do you plan to cook or serve food or beverages?*

    1. Yes
    2. No
29. If yes, describe
33. For and in consideration of meeting room and City Hall facilities usage,
    any organization using same hereby agrees to indemnify and hold harmless the City of Muskego from any and all actions or lawsuits relating to its use of such rooms and facilities. Further, such organization agrees to reimburse the City of Muskego for any and all repair costs and for any and all damage as may be caused directly or indirectly to the room and/or facilities by such use thereof. If any organization refuses to pay for repairs, the matter will be referred to the City Attorney for legal action. The City Hall Meeting Room Policy has been read, is hereby acknowledged, and will be complied with in full.
35. I have read and agree.*

    1. Yes

    1. No
37. Name and Date*
39. For Office Use Only
    Date received by the Clerk's Office
41. Rooms cannot be reserved until a signed application is on file.
Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit Submit and Print

* indicates a required field