Barricade Request

Please complete the information below to request a barricade.

First Name

Last Name

Middle Initial

Street Address

Apt/Unit #

City

State

Zip Code

Phone

E-mail

Date of Event

Date barricades will be delivered or picked up:

Date barricades will be returned

Location of Event: (Must be a City owned Park, Facility, or Public ROW):

Is applicant's organization a non-profit?

Number of barricades being requested:

Note: Submission of an application does not guarantee rental of barricades. Applicant will be contacted when the application is approved, and a rental agreement will be sent for completion. Payment must be made before barricades are delivered to the site of the event.

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