GOSHEN TOWNSHIP RENTAL APPLICATION
Name of Renter/Organization _______________________________________________________
City____________________________ State______________ Zip Code _______________________
Date of Event: (mm/dd/yyyy) ______________________________
Type of Event: ___________________________________________________________________
Requested Time: ___________________________________________________________________
*Any Continuous 6 hour period between & - $75.00 + $50.00 Deposit (2 separate checks)
*Any additional hours - $10.00 per hour.
*All requests are subject to availability.
PLEASE keep a copy of the Rules and Regulations.
All fees must be paid
Cancellation and return of fees is permitted with notification received in writing (7)
days prior to the event. Late cancellations will result in forfeiture of your rental fee.
As Registrant, you agree to be personally responsible for the cost of repairs and/or
cleaning necessitated by
significant damage to the
signature you acknowledge that you have received a copy of the Rules and
Regulations and will adhere to them. You will also be obligated to pay any increase
in deposit or rental fees if deemed necessary.
Property damaged caused by decoration, food, or insufficient cleaning of the premises
may result in the forfeiture of the security deposit and an additional charge for extra
SIGNATURE OF APPLICANT DATE
AMOUNT OF PAYMENT____________________ CHECK#1________ CHECK#2________ CASH $_________