Fillable Facilities-Usage-Agreement Recreation Facilities Agreement

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Facilities-Usage-Agreement Recreation Facilities Agreement

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Parks, Recreation & Senior Program Departments
Facilities Usage Agreement
Parks, Recreation Program
Administrative Office
906 Tafoya Dr.
PO Box 1270
Gallup, NM 87301
Phone: 505-726-5490 Fax: 505-726-7540
City of Gallup Parks, Recreation & Senior Program
Departments
Facilities Usage Agreement
Instructions
1. Call the Recreation & Senior Program Administrative Office at 505-726-5460 and ensure your
dates are still available. (Dates will not be scheduled until a deposit has been made)
2. Complete this Facilities Usage Agreement Packet and return to this office at the Aquatic Center
located at 620 South Boardman Avenue. (Parts 1-2 are to be submitted prior to event, Part 4 is to
be submitted after event, Instruction and Rules & Requirements are for your information and
file).
3. Completed packets, payment of all money due, proof of insurance, etc. must be submitted
TWO (2) WEEKS PRIOR (10 working days) to event/activity. Attach verification of
insurance. Approval cannot be granted without verification of insurance as required by the
City of Gallup Risk Management Office.
4. For any Cancelations on Tournament, please notify the Recreation & Senior Program
Administrative Office at 505-726-5460 24 hours prior to event.
5. Attach a game and/or practice schedule to your packet as applicable. Any schedule changes must
be approved through the Office. Do NOT assume scheduling changes can be made without
approval. Do not assume we can read your mind regarding schedule changes.
6. Leave the applicable deposit when submitting your packet. Checks or money orders only please!
Dates will not be reserved until a deposit is received.
7. Take your receipt with you (Parts 3 and a hand written copy). This is also your copy of the dates,
times, and fields approved for your event. Please follow these rules and requirements.
8. The Executive Director of Parks & Recreation will review your packet and either approve
or disapprove it on a case-by-case basis. Submission of a completed Facilities Agreement
does not guarantee approval. The Recreation Administrative Personnel will contact you to
notify you of the decision. The approval page may be picked up at the office so you have
verification of the scheduling of your event.
9. After your event make sure the area you used is better than when you arrived.
10. Submit the Statement of Benefit (Part 4) to the Office. If event was cleaned, the clean-up fee will
be refunded to your organization. Refund of any applicable deposits will only be processed upon
request by the organization and receipt by the Recreation & Senior Program Administrative
Office of the Statement of Benefit. (Deposits will be processed through a City of Gallup check
written to your organization and mailed to the address provided on the Facilities Agreement).
Any refunds awarded back to the organization may take up to 30 days.
11. This Statement of Benefit does NOT replace the annual Financial Statement. All leagues must
submit an annual Financial Statement upon the conclusion of the season or before 5 weeks
(around February 5
th
) of the first of the year.
City of Gallup Parks, Recreation & Senior Program
Departments
Facilities Usage Agreement
Rules & Requirements
(This portion for user)
REQUIREMENTS & RULES:
1.
A $200.00 deposit is required to reserve your dates of tournament (will place you on calendar and
this deposit will go toward your overall fees).
2. Must have proof of insurance, Commercial General Liability (Due 2 weeks before event)
3. Must have certified umpires and officials sanctioned through ASA or USSSA or equivalent.
4. Payment of fees as requested. Due 2 weeks before event.
5. No alcoholic beverages or illegal drugs per City ordinance. Agreement person(s) shall be
responsible for penalties/damages caused by participants.
6. No vehicles of any kind are allowed on fields for any reason. Only rakes may be used for field
dressing. Absolutely NO vehicles are allowed inside the fenced areas of parks -- all tables,
chairs, grills, etc. must be carried in.
7. You will have to provide your own bases for use on the fields.
8. Fires are to be placed in designated grills and fireplaces (you may bring in your own). All grills
and fireplaces are to be properly extinguished when finished with them.
9. Lights/scoreboard shall be turned off no later than 10 minutes after the last game. Failure to do
so may result in forfeiture of deposits.
10. Area including dugouts, playground, ball fields, bleachers, picnic tables, etc. must be cleaned of
trash. Failure to do so may result in forfeiture of deposits.
11. A park permit is required for parties of more than 150, if a PA system will be used, or if food will
be served.(A food service permit may also be required). (These are obtained through the City
Clerk’s Office)
12. Arrangements for keys for bathrooms and lights must be made in advance with the Parks
Director. All keys must be returned the next business day after the event. All buildings and
bathrooms must be locked or there will be a forfeiture of deposit.
13. Read and sign waiver as part of this packet. Waiver can also be used for each participant if you
so choose.
14. ALL activities must be concluded and the lights must be turned off by 10:00pm in ALL
facilities.
15. Rules for the turf fields (Mickey Mantle, Girls Softball, Pee Wee Reese & Stafie) are as
follows:
NO SEEDS, GUM, CANDY, FOOD or DRINKS (of any kind)
NO METAL CLEATS
NO TOBACCO (smoking, chewing, or cigarette butts)
NO PETS (of any kind, on or off leash)
NO SOFT TOSS (hitting balls against the fence)
NO CHAIRS (of any kind)
NO SPECTATORS ON THE TURF (spectators are welcome in the bleachers but NOT
inside the fence or on the turf)
THESE RULES ALSO APPLY TO THE DUGOUTS & SIDELINES. The only drink
permitted in dugouts or on sidelines is water and water only!
THESE RULES ARE FOR THE PROTECTION & LONG LIFE OF THE TURF --
PLEASE FOLLOW THEM!
The Contact Persons (or “Home Team”) for the event are responsible for ensuring requirements
and rules are followed.
Failure to abide by these rules may result in forfeiture of further usage by
individuals or the organization as a whole.
City of Gallup Parks, Recreation & Senior Program
Departments
Facilities Usage Agreement
Part 1- Request Letter/ Application
The following application serves as my request to use the City of Gallup Parks and Recreation facilities. I
have received and understand the rules and policies governing the usage of these facilities and acknowledge
that submission of this application serves as agreement to abide by these rules and policies. I understand that
submission of this request and agreement does not constitute approval of facility usage.
Today’s Date: __________________
Name of Function/ Tournament:_________________________________________ Non-Profit? Y/N
(please circle)
Organization Name: _________________________________________________ Adult/Youth (please circle)
Person in Charge: _____________________________ Email:____________________________
Home Phone:____________________________
Address _______________________________City _________________ State _______ Zip __________
2
nd
Contact Person:_____________________________ Email:____________________________
Home Phone:____________________________
EVENT DETAILS:
Dates of Event: _______________________________ Dates of Season: _________________________
Start Time: __________ End Time: __________ #of Teams: _______ # of Participants: __________
Type of Event (please circle):
Tournament Game Practice Sports Season (leagues, schools, etc.) Other: _____________
(PLEASE ATTACH PRACTICE AND/OR GAME SCHEDULE)
FACILITY:
Sports Complex Fields: #1 (SW) _____ #2 (NW) _____ #3 (NE) _____ #4 (SE) ____________
Ford Canyon Complex: Girls _____ Stafie _____ PeeWee _____ Mickey Mantle ______
Other Fields: T-Ball _____ Indian Hills ___ (TDFL) _____ Father Dunstan _____
Soccer Complex _____
Other Facility: _____________________________________________________________________________
Specific Needs/Requests:
_________________________________________________________
___________________________________________________________________________
For all repetitive or seasonal requests (ie: school team games or league seasons) please attach a full and
complete schedule both for games and practices if field usage is desired for both.
_______________________________________________ ________________________________
Signature of Person in Charge Date
PLEASE READ AND SIGN WAIVER on PART 2
City of Gallup Parks, Recreation & Senior Program
Departments
Facilities Usage Agreement
Part 2 – Waiver of Liability
RELEASE, INDEMNIFICATION & ACKNOWLEDGEMENT
(To be signed by Group Representatives, Adult Participants, or Parent/Guardian of Participating Minor)
In return for _____________________________ being allowed to participate in activities
of the City of Gallup Parks & Recreation Departments, or to use equipment of City
Facilities operated by said departments, today and at any time in the future , I hereby
agree as follows:
1) Release:
I release the City of Gallup Parks & Recreation Departments, its directors, employees,
boards, agents, successors, and assigns from all liabilities, claims, causes of action, of any
kind or nature whatsoever, breach of contract or any other fault, in any way relating to or
arising at any time out of my participation (or my child’s participation), in any activity of the
City of Gallup Parks & Recreation programs, use of equipment or facilities.
2) Indemnification:
I assume liability for, and agree to indemnify, protect, hold harmless the City of Gallup
Parks & Recreation Departments, its directors, employees, boards, agents, successors and
assigns from all liabilities, losses, damages, expenses, (including reasonable attorney fees),
claims, suits and causes of action, of any kind or nature whatsoever, breach of contract or
any other fault, in any way relating to or arising out of my child’s participation and/or adult
participation in any activity of the City of Gallup Parks & Recreation Departments or use of
equipment or facilities.
3) Acknowledgement:
I acknowledge that I have received a copy of the rules and that I have read and understand
these rules. I acknowledge that by signing this agreement I am agreeing to follow and abide
by these rules and policies. I understand that failure to abide by these rules may result in
forfeiture of future use of the City of Gallup facilities.
I have read and understand this agreement. I understand that by making this
agreement, I surrender valuable rights. I do so freely and voluntarily.
______________________________________________________
Signature of Adult Participant or Parent/Guardian of Minor
______________________________________________________
Printed Name
______________________________________________________
Date
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City of Gallup Parks, Recreation & Senior Program
Departments
Facilities Usage Agreement
Part 3- Participant Payment Receipt
City of Gallup Parks & Recreation Office Use Only
REQUIRED ATTACHMENTS:
Park Permit Required? yes no Date Received: ______________ (Please attach)
Insurance Required? yes Date Received: ______________ (Please attach)
Non-Profit Organization Tax ID #: _______________ Date Received: ______________ (Please attach)
Season Schedule: HS Varsity HSJV Youth League Adult League Practice Other___________
PAYMENT
1. Facility Fees: (see fee schedule) _____________
2. REQUIRED lining fees: $20.00 per field/per day _____________
3. $100.00 refundable deposit - clean up fee _____________
4. Any Other Fees: ____________________________________ _____________
Total Fees Required: _____________
($200.00 Deposit will be required to hold dates – will go toward payment of total fees)
Total Fees Required: _____________
Deposit Paid Amount: _____________ Received by: ______________________________
Date Paid: ____________ Check #: __________
Balance Due: _____________
Total Balance Collected: _____________ Received by: ______________________________
Date Paid: ____________ Check #: __________
EVENT DETAILS:
Person in charge: _____________________________ Phone: ______________________________
Dates of Event: _______________________________ Dates of Season: _________________________
Start Time: __________ End Time: __________ #of Teams: _______ # of Participants __________
Type of Event (please circle):
Tournament Game Practice Sports Season(leagues, schools, etc.) Other: _____________
(PLEASE ATTACH PRACTICE AND/OR GAME SCHEDULE)
FACILITY:
Sports Complex Fields: #1 (SW) _____ #2 (NW) _____ #3 (NE) _____ #4 (SE) ____________
Ford Canyon Complex: Girls _____ Stafie _____ PeeWee _____ Mickey Mantle ______
Other Fields: T-Ball _____ Indian Hills ___ (TDFL) _____ Father Dunstan _____
Soccer Complex _____
Other Facility: _____________________________________________________________________________
Specific Needs/Requests:
_________________________________________________________
City of Gallup Authorization:
_________________________________________________ ________________________________
Signature of Parks or Recreation Executive Director Title
________________________________
Approved/Disapproved (Please circle) Date
City of Gallup Parks, Recreation & Senior Program
Departments
Facilities Usage Agreement
Part 4 - Statement of Benefit
This Statement of Benefit must be submitted before any refund of deposit will be made. This statement
does NOT take the place of an annual Financial Statement
Today’s Date: __________________ Person in Charge: _____________________________________
Name of Tournament/Function:_________________________________________ Non-Profit? Y/N
Organization Name: _________________________________________________ Adult/Youth
(please circle)
EVENT DETAILS:
Dates of Event: _________________________________ Start Time: __________ End Time:
_________
Number of Teams: _________ Total #of participants: __________ #Youth: ______ # Adults: ______
Purpose of Event: __________________________________________________________________________
FACILITY:
Which facility did you use? __________________________________________________________________
Did you have a park permit? Y/N Was the facility ready for usage? Y/N
Did you have what you asked for on your facilities request? Y/N
Did you use lights? Y/N Did you require striping? Y/N Did you have a concession
stand? Y/N
Other Comments:
_________________________________________________________________________________________
_________________________________________________________________________________________
BENEFIT:
How much did you charge? _____________ How did you charge? (ie: per team, admission fee for everyone, per participant)
_________________________________________________________________________________________
Please complete balance sheet below:
Dollar
Amt
Transaction Description
Dollar
Amt
Income Statement
Money brought in:
Expenses Paid Out:
Total Money Brought
In
$
Admission Fees
$
Tournament Fees
$
Subtract Total
Expenses Paid Out
-
$
Team Entry Fees
$
Lining Fees
$
Net Income
=
$
Sponsorship
$
Deposits Paid
$
Concession Stand
$
Equipment Expenses
$
For Office Use Only
Other Income
$
Concession Expenses
$
Date Received
Other Notes:
$
Other Expenses
$
Received by
$
$
Area Cleaned
$
$
Refund of Deposits
Total Money Brought In:
$
Total Expenses Paid Out:
$
Date/# of Refund Chk Req
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Completed 12 July 2020

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