Township Hall Reservation – Burtchville Township

Burtchville Township Hall

7095 Second Street, Lakeport Michigan 48059 Phone: (810) 385-5577 Fax: (810) 385-8551

Rental Application and Agreement

This agreement is not final until fees are paid

Rental Fee: $100.00 Deposit: $50.00 Total Due: $150.00
Make Check payable to Burtchville Township
You must be a resident to reserve.
Printable Form

* Indicates required fields

Your Name*
Your Email*
Person applying for use*
Address*
City*		State*
Contact Person*	Phone*

Description of use*:

Date of Event*:	Time to Open*:	Time to Close*:
Will Food Be Served? YesNo

INDEMNITY BY APPLICANT The Applicant acknowledges receipt of a copy of the Policies and Rules and agrees to comply. Applicant shall indemnify the Township and save it harmless from and against any and all claims, actions, damages, liability and expense in connection with loss of life, personal injury and/or damage to property arising from or out of the occupancy or use by Applicant of the premises or any part of the Township property occasional, wholly or in part, by any act or omission of Applicant, its agent, contractors or employees. I, HEREBY, AGREE TO THE FOREGOING TERMS AND CONDITIONS OF THIS AGREEMENT