Athletic Facility Rental Application
Applicant Information
Name Date of birth
Address City State Zip
Email address
Primary phone Secondary phone
Event Information
Date Time Attendance Description
Date Time Attendance Description
Date Time Attendance Description
Location
X Location X Location X Location X Location
Brookview Park
Davis Comm. Center
Gearty Park
Glenview Terrace Park
Hampshire Park
Lions Park
Medley Park
Schaper Park
Scheid Park
Seman Park
Tyrol North Park
Tyrol South Park
Wesley Park
Wildwood Park
Yosemite Park
Other:
Facility (Fees do not include tax)
Facility Options Fee # Hours Total
Baseball Field
Softball Field
Soccer Field
per hour, no attendant
per hour, with attendant
(two-hour minimum)
$25 Res, $35 Non-res
$35 Res, $50 Non-res
lights (per hour)
$10
Pickleball Court
Tennis Court
weekday, per hour, per court
$6 Res, $8 Non-res
tournament, per day, per court
$50 Res, $60 Non-res
Outdoor Hockey Ice Rink
Outdoor General Ice Rink
per hour $25 Res, $35 Non-res
Indoor Volleyball Court
(Davis only)
per hour, per court $30 Res, $40 Non-res
Sand Volleyball Court
(Brookview Park only)
per hour, per court $20 Res, $25 Non-res
Basketball Court
(Davis only)
per hour, per court $30 Res, $40 Non-res
Tax
Total Due
Consent And Release Of Liability
The holder of this permit agrees to save, defend, and hold harmless the City of Golden Valley for any damages to City personnel, facilities, equipment, or other City property, or to the
property and/or person of any third party, resulting from the use authorized hereby. The City of Golden Valley shall not be liable for damage to the property of any person participat-
ing in the activities authorized hereby, nor shall it be liable for the death or injury of any such person occurring as a result of the use of the facilities authorized hereby unless damage,
injury, or death is due to gross negligence or reckless misconduct of the City. RENTAL FEES: Are generally required for all specic uses. Full payment for rental is required within 10 days
of reservation. Permit will be processed when payment is received. Only 50 percent of rental fee refunded when facility reservation is canceled; no refund for cancelations requested
with less then ve business days before facility rentals. City-sponsored leagues, programs, and events, school district athletics, programs and events, and recognized Golden Val-
ley-based youth athletic associations do not pay the established rental fee for the use of such property (enterprise operations excluded). ALCOHOL: No person shall possess, display,
consume, or use alcoholic beverages on any City park property. SMOKE FREE ENVIRONMENT ORDINANCE: Tobacco use of any kind is prohibited in Golden Valley park and recreation
facilities. Reservations for athletic facilities will follow Golden Valley’s GUIDELINES FOR PARK AND ATHLETIC FACILITY USE PERMITS, including priority usage of parks and facilities.
Signature of responsible party: __________________________________________________________ Date: ______________________
Parks & Recreation Department
| 316 Brookview Pkwy S, Golden Valley, MN 55426
763-512-2345 | TTY: 763-593-3968 | www.goldenvalleymn.gov
Cash Check #_________ Visa/Mastercard/Amex/Discover # ___________________________
Expire: ________ SecCode: _______
Signature for card ________________________________
For Ocial
Use Only
Date received by Date processed by Amount paid
9/19
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signature
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