|
|
OLD FORT PARKS & RECREATION FIELD RENTAL PERMIT
NAME OF FIELD: _________________________________________________ ORGANIZATION: _________________________________________________ ADDRESS:_______________________________________________________ GROUP MANAGER/SUPERVISORS NAME:____________________________ ADDRESS: ______________________________________________________ TELEPHONE (HOME): __________________ (BUSINESS):________________ DATE TO BE USED: _______________________________________________ HOURS: FROM: ____________________AM UNTIL: __________________PM ____________________PM UNTIL: __________________PM FOR WHAT PURPOSE: ________________________________________________________________________________________________________________________________ TOTAL NUMBER OF PERSONS PARTICIPATING IN PROGRAM: ___________ FEE TO BE CHARGED:_____________________________________________ PAID: _____________DATE:__________ EMPLOYEES INITIALS:___________ SIGNED:______________________________ TITLE:_____________________ I/WE, THE UNDERSIGNED, AGREE TO ABIDE BY ALL THE DEPARTMENTAL BALL FIELD OPERATING REGULATIONS AND RESERVATION POLICY AND TO ASSUME FULL RESPONSIBILITY FOR ANY AND ALL DAMAGES TO PREMISES AND/OR PERSONAL INJURY THAT MAY OCCUR TO PERSONS OR PROPERTY RESULTING FROM OUT USE OF THE OLD FORT RECREATION DEPARTMENT FACILITY SPECIFIED ABOVE AS SET FORTH IN THE GUIDELINES AND FIELD RESERVATIONS.
SIGNATURE:___________________________________________DATE:__________________ PAM VANCE TOWN OF OLD FORT PARKS & RECREATION DIRECTOR The Town of Old Fort does not discriminate on the basis of disability in the provision of its services as charged by the Board of Aldermen of the Town of Old Fort. All meetings are held in accessible facilities. Any person with a disability needing special accommodations should contact Pam Vance at least 48 hours prior to the scheduled meeting.(668-4244 ext.18) |