New Submission

Request to Use the County of Franklin, PA Property
Which county property would you like to request use of?*field type radio button
Which county property would you like to request use of?Courthouse PlazaHood Street Parking Lot2nd St/Route 30 Parking LotAdministration Parking Lot

Organization or group name*field type single line
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Organization contact person*field type single line
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Address*field type single line
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City*field type single line
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State*field type single line
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Zipcode*field type single line
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Contact phone number*field type single line
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Fax numberfield type single line
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Email address*field type email

Event name*field type single line
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Event description*field type multi line
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Event date*field type date
Event start time*field type time
Event end time*field type time
Estimated number of participants*field type number
Will this be a reoccurring event?field type radio button
Will this be a reoccurring event?NoYes

Additional date/times being requested

	Date/Start Time*field type date	Date/End Time*field type date
Row 1×	Date/Start Time*field type date	Date/End Time*field type date	×

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Upload supporting documentationfield type file upload
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The undersigned represent that they are authorized to execute this agreement on behalf and as an agent of the party identified herein as the entity making use of the County facility at the times and places set forth in the paragraphs above. The entity making use of the County facility does hereby release, remise and waive all claims of damages of any kind or nature against the County of Franklin and any of its officials, employees, agents and assigns from any and all claims for damages, injuries or losses that may arise from the use of the Franklin County facility and that the individuals executing this release acknowledge that they have the authority of the entity making use of the Franklin County facility to bind the entity and its members of any invited guests to the terms of this release. The entity also agrees to indemnify and hold harmless the County and to reimburse the County for any and all losses, damages and claims of loss incurred by the County including any claims for personal injury or monetary losses of any kind made or claimed by any individual resulting from the entity’s use of the Franklin County facility as identified in the terms of this agreement.
By checking the 'Agree' checkbox you confirm that you have read and acknowledge the Disclosure statement*field type checkbox
By checking the 'Agree' checkbox you confirm that you have read and acknowledge the Disclosure statementAgree
Name of person submitting this application*field type single line
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Submitter's telephone numberfield type single line
only complete if different than the phone number entered on the "Event Info" page
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Submitter's email addressfield type email
only completed if this email address is different from the one provided on the "Event Info" page
Date submittedfield type date
Date and time will be captured on form submission

Franklin County Property Use Request