2. Reservation Date & Time*
   Reservation Date & Time

   Reservation Date & Time
3. Facility / Facilities Requested*
5. Organization or Group*
6. Point of Contact*
8. Address*
10. City*
11. State*
12. Zip*
14. Email*
15. Phone*
19. Description of Event*
    Include estimated number of participants, time or range of times, and any special needs. Please attach event brochure and/or pictures of past events, if available, additional info sheets okay. A normal rental period is 4 hours.
21. Please return your application 30 days prior to your requested reservation date. Ozaukee County requires that all requests be reviewed by staff to avoid any conflicts. A $200 refundable deposit will be charged as part of the approval process. The organization or sponsoring group must provide liability insurance; have a certificate issued naming Ozaukee County as an additional insured. The facilities are to be left in satisfactory, as is condition . Any damage or excessive clean-up will result in a maintenance billing, loss of refundable security deposit, and the possible loss of your group’s privilege to use the facility in the future.
23. Signature*
    I acknowledge the above requirements for the group use of the Ozaukee County facilities.
24. Date*
    Date

    Date
26. The organization or group (sponsor) must provide their own liability insurance. The group or organization listed above hereby agrees to list Ozaukee County as additional insured’s on their liability policy of a minimum of $500,000 and provide a certificate of insurance for the event(s), fully indemnifying Ozaukee County for any and all damage or injury to any persons or property, which is in any way at attributable to the above referenced event at the Ozaukee County Facilities.
    
    Under no circumstances will Ozaukee County be held responsible for damage to the Ozaukee County Facilities, or be held responsible for damage to an adjoining private property as a result of the above referenced event. The organization or group (sponsor) listed above accepts all such responsibility and agrees to indemnify Ozaukee County fully for any such claims.
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28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

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