First Name
Last Name
Street Address
Primary Phone Number
Secondary Phone Number
Email Address
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Event Date
Start Time
End Time (Block parties must end (including cleanup and teardown) by 11 p.m.
Name of the street on which the party will occur
Additional Location Information (closest cross streets, cul-de-sac, etc.)
Would you like to reserve baricades?Yes
No
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By clicking “submit” the block party applicant waives and holds harmless the City of Portage, its officers, agents or representatives and employees, from and against any and all liability, actions, causes of actions, claims known and unknown now or in the future that may arise out of the hosting of a block party.