| Your full name (first and last) |
|
|
| Organization/Agency |
|
Paynesville Chamber of Commerce |
| Phone number |
|
|
| Email address |
|
|
| Address of event |
|
605 Lake Ave S |
| Name of event |
|
Town and Country Days |
| Location of event |
|
Ambulance Garage open lot |
| Purpose of the stage at your event |
|
We will be hosting a free concert during the Town and Country Days celebration |
| Contact for during event (first and last name) |
|
|
| Phone number for contact during event |
|
|
| Date(s) requested |
|
6/20/2025 |
| Pick up date and time |
|
TBD |
| Return date and time |
|
TBD |
| We, the users of the Spicer Commercial Club stage/showmobile, understand that we assume full responsibility for any damage, theft, or loss to the stage unit and its accessories between the time we pick up the portable stage at the Spicer City Works yard and the time we return the stage to the same location. |
|
Yes |
| Electronic Signature (simply type your name) |
|
|
| Date (month, day, year) |
|
March, 22, 2025 |
