Fillable Facility Use Application Pools (City of Winchester)

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Facility Use Application Pools (City of Winchester)

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BROWSE CITY OF WINCHESTER (VA) FORMS

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Revised 2/21/2018
Winchester Parks & Recreation Department
1001 East Cork Street • Winchester, VA 22601
Phone: (540) 662-4946 • Fax: (540) 678-8791
wincparks@winchesterva.gov • www.winchesterva.gov/parks
Indoor Pool
Outdoor Pool
2
General Information
Making a Reservation
The Winchester Parks & Recreation Department permits individuals, businesses, civic groups and other
organizations to use park facilities.
To secure a facility for a rental less than $200, payment in full of the total cost of use is due at the time of
booking along with the Facility Use Application. If the reservation is $200 or more, a 30% deposit is
required to secure the reservation with the remaining balance of the rental fee due within ten (10) business
days of the requested date.
Applications for rentals that are open to the public require a copy of a City of Winchester Business license
if goods or services are being sold. It is the responsibility of the applicant to contact the Commissioner of
Revenue to determine if a business license is required.
A copy of the insurance is required. A general liability policy with $1,000,000 combined single limits.
Coverage is to be on an occurrence basis with an insurer licensed to conduct business in the
Commonwealth of Virginia. The insurer must have an A.M. Best rating of A- or better. The insurer must
list the member locality as additionally insured. The endorsement must be issued by the insurance
company. A notation on the certificate of insurance is not sufficient.
Applicants must be 21 years of age or older.
Facility Checklist
A checklist will be completed by the recreation attendant or park staff at the beginning as well as the
conclusion of the event. As long as a check has been satisfactorily completed and there are no damages, no
additional fees will be charged to the household. If the facility has been left in unsatisfactory condition, a charge
for time and materials will be billed. No future reservation can be made until the fee is paid.
Large special events require a Special Event Application and must be submitted at least 60 days in
advance. Special event applications can be downloaded from our website at winchesterva.gov/parks
under the
Special Events – Hosting an event tab. All special event applications should be returned to the Leslie Bowery at
Winchester City Parks and Recreation Department at 1001 E. Cork St. Winchester, VA 22601 for review. This
Facility Use Application should be submitted to the Winchester Parks & Recreation Department directly that can
be downloaded from winchesterva.gov/parks.
Cancellations or Relocation
Submit cancellations, in writing, no less than three (3) business days prior to the scheduled event. A 30%
processing fee will be retained if the reservation is cancelled prior to three (3) days of the date. Cancellations
made within three (3) business days will not be refunded.
Inclement weather-The Winchester Parks & Recreation Department reserves the right to close any facility or
cancel rentals and activities if inclement weather is eminent. In the event of a need to cancel a reservation at the
Outdoor Pool due to an impending storm, the applicant should call the Outdoor Pool at 540-667-2284 and speak
with a manager no later than 6pm. Should the applicant proceed with the reservation, the Winchester Parks and
Recreation Department reserves the right to clear the facility whether it be temporarily or permanently for the
safety of patrons and staff. Cancellations during a rental will result in a partial refund in which a 30% processing
fee will be retained. Customer initials______ WPRD Staff initials_____
All efforts will be made to keep approved facility reservations intact; however, the Winchester Parks &
Recreation Department reserves the right to relocate or cancel a function if necessary.
3
Facility Use Rules and Guidelines
The Winchester Parks & Recreation Department strives to provide quality facilities for your use. The
following rules and guidelines are in place for everyone’s safety and enjoyment of park facilities.
General Rules for Use of All Facilities
Minimum reservation of 2 hours is required for pool reservations.
City of Winchester sanctioned activities, special events, and approved community partners have first
priority use of all facilities.
Posting of any signage or balloons on trees, posts, fencing, light poles, and gates is prohibited.
No group or organization may, under any circumstances, adjust or change the settings of any electrical
switch or control, including lighting, heating, and cooling systems, without approval of the facility staff.
Non-profit Applicants are required to provide proof of tax status (501-C3) including address prior to
receiving the non-profit rate. The non-profit rate will only be honored for those non-profit entities that
reside within the City of Winchester limits.
For-profit Applicants are required to have a general liability policy with $1,000,000 combined single
limits and are to follow the outline on page 2.
Applicant agrees to reimburse the City of Winchester for any damage of public property as a result of the
user’s use of the facility. Groups are responsible for all damages and cost associated with the damages.
Decorations shall not be taped, nailed stapled or fixed in any way to walls, doors, glass, lights, electronic
equipment, or ceilings.
No candles or open flames are permitted.
The Applicant certifies that the information given in the application is correct. Falsification of
information on the application will result in immediate dismissal from the facility, forfeiture of all fees
paid including any deposits and denial for future use.
All facility users shall not exclude anyone in participation, denies anyone benefit of, or otherwise subject
anyone to discrimination because of the person’s race, color, national origin, age or disability.
Applicant is responsible for compliance with Americas with Disabilities Act, as it relates to the event,
performance, and services to be provided in relation to the event for individuals with disabilities.
Applicant hereby guarantees and assumes full and exclusive responsibility for the safety of persons and
property of all participants and activities including, without limitation, players, participants, staff,
officials, agents, or lessee, spectators, and members of the public in attendance at either activity
contemplated hereby, or actually conducted by the Applicant.
The park is not responsible for any lost, stolen, or misplaced personal items or equipment.
Applicant and its guests will comply with all rules and regulations established by the Winchester Parks &
Recreation Department. The Parks & Recreation Department reserves the right to dismiss any persons
from the facility. Applicant understands that Parks staff has the authority to determine if participants are
strictly adhering to all rules and regulations, and we have the full authority to enforce these regulations.
Parks staff must be respected and obeyed. NO foul language will be permitted.
All persons and activities must comply with local, state and federal laws. This includes the prohibition of
use and/or possession of weapons, alcohol, any illegal substances on the property. If you suspect anyone
attending your event is intoxicated or under the influence of drugs, it is the applicant’s responsibility to
escort them off of the property.
Applicant agrees to notify and request permission for the sale of items including but not limited to tickets,
goods or services and if admission fees are sold or collected at said event.
All noise and music must be kept to a minimum. Park staff will determine if the noise or music has a
negative impact on other activities and has the authority to order it be turned down. Excessive noise will
result in applicant’s forfeiture of future facility use.
Users are required to remain in their designated rental area and shall not use other areas, other than
restroom facilities, without permission.
4
Indoor Pool Use
Applicant is responsible for providing supervision at a ratio of 4-to-1 for all children under the age of
twelve (12). Supervisor must be at least eighteen (18) years of age and be present at the facility and in the
water with the children if pool facilities are used.
Lifeguards will clear the pool 15 minutes prior to ending time. Clean-up must be complete by the end of
your rental time.
15 minutes will be allowed before the rental for set up. The use of the Pool lobby comes with the rental
of the Pool.
No food or drinks will be permitted in the pool area.
Use of tobacco is not permitted indoors, on or within 50 feet of the War Memorial Building. Alcoholic
beverages are not permitted on any park grounds or in any park building.
All users must follow the posted rules and regulations.
Proper swim attire must be worn.
Applicant agrees that children who are not toilet-trained must wear disposable swim diapers or reusable
swim diapers in order to be allowed in any pool. Failure to comply with this rule may cause the renter to
incur a cost to clean the pool and may be subject to the imposition of charges for violation of this rule.
Park staff reserves the right to restrict admission to public pools to anyone with skin abrasions, colds,
coughs, extremely inflamed eyes, infections, or wearing bandages.
Outdoor Pool Use
Applicant is responsible for providing supervision at a ratio of 4-to-1 for all children under the age of
twelve (12). Supervisor must be at least eighteen (18) years of age and be present at the facility and in the
water with the children if pool facilities are used.
Lifeguards will clear the pool 15 minutes prior to ending time. Changing and clean-up must be complete
by the end of the requested rental time.
15 minutes will be allowed before the rental for set up.
Food and drinks are permitted in certain areas. Food and drink is not permitted in the pools.
Use of tobacco is not permitted within 50 feet of the Outdoor Pool. Alcoholic beverages are not
permitted on any park grounds or in any park building.
Tables and a charcoal grill are available for use. Applicant is responsible for all grilling supplies. Health
permit is required if food is being sold.
All users must follow the parks rules and regulations.
Proper swim attire must be worn.
Applicant agrees that children who are not toilet-trained must wear disposable swim diapers or reusable
swim diapers in order to be allowed in any pool. Failure to comply with this rule may cause applicant to
incur a cost to clean the pool and may be subject to the imposition of charges for violation of this rule.
Park staff reserves the right to restrict admission to public pools to anyone with skin abrasions, colds,
coughs, extremely inflamed eyes, infections, or wearing bandages.
OTHER RULES MAY APPLY TO YOUR USE. THE PARK RANGER AND DESK ATTENDANT
RESERVE THE RIGHT TO ENFORCE OTHER RULES TO PROTECT CITY PROPERTY AND
ENSURE ORDER AND PEACE.
5
NO ALCOHOL PERMITTED ON PARK PROPERTY
______________________________________________________________
Facility Use Application
Event Date: ___________________ Hours of Event: From _______am/pm To _______am/pm
(Request must include set-up and clean-up time)
Name of Person/Organization Requesting use: ______________________________________________________
Mailing Address: _____________________________________________________________________________
City: _________________________________________ State: ____________ Zip Code: __________________
Contact Person: ___________________________________ Day Phone: ________________________________
Evening Phone: _______________________________ Mobile Phone: _________________________________
Email: _____________________________________________________________________________________
Type of Event: _______________________________________________________________________________
Size of Group/Estimated Attendance: ___________ (Note: If group exceeds room capacity, the function will be
terminated without refund)
Will your group be selling anything at this event? ____Yes ____ No
If yes, do you have a City of Winchester business license? ____ Yes ____ No
(No group will be permitted to sell anything without prior park approval and a business license)
Facilities Requested: □ Indoor Pool (80 occupant load)
□ Outdoor Pool (300 occupant load)
Are you bringing a charcoal grill? ___ Yes ___ No
Facility Rental Fees: See current Facility Rental Fee Schedule for a full list of fees.
Cleaning Charge
I understand I am responsible for my set up and clean up. If the facility is not left in satisfactory condition, I will
be charged time/materials to return facility into original condition. This fee must be paid ten (10) business days
after my reservation if I have left the facility in unsatisfactory condition. No future reservation can be made until
the fee is paid._____ (initial)
I agree to pay additional fees if I have not vacated the premises by the reservation end time. ___ (initial)
__________________
Application Date
6
Facility Rental Fee $________ Deposit Amount $________ Amount Owed $________
Please forward the Facility Use Application, rental fee, and deposit to:
Winchester Parks & Recreation Department
1001 East Cork Street
Winchester, VA 22601
Questions? Call 540-662-4946
Fax 540-678-8791
This document shall be governed by the laws of the Commonwealth of Virginia. The Applicant shall indemnify
and hold the City of Winchester, its employees, agents, and representatives harmless from all suits, actions, claims
of any kind, including attorney’s fees brought on account of any personal injuries, property damage, or damages
of any kind, or violations of any rights, suffered by any persons or property in consequence of any neglect in
safeguarding contract work, or on account of any act or omission by applicant or its employees, volunteers or
participants. In addition, applicant shall indemnify and hold the City of Winchester, its employees, agents, and
representatives harmless from any claims or amounts arising from violation of any law, and for any agents, or
assigns related to the performance of this MOU and shall be responsible for all damages, costs, expenses, and fees
including but not limited to reasonable attorney’s fees associated therewith.
I have read, understand and agree to abide by the Facility Use Rules and Guidelines incorporated into this
document and associated with my rental of the facility. I have the authority to act in behalf of the above-named
organization and I accept responsibility for actions and behavior of all participants.
For new renters:
I have received a copy of the rules and regulations for using the facility and understand these rules and the
cancellation policy.
Signature: ______________________________________________ Date: __________________
For return renters:
I have been offered a copy of the rules and regulations for using the facility.
o I accept a copy
o I decline a copy at this time
I understand the rules and the cancellation policy. Initials_____
Signature: ______________________________________________ Date: __________________
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Facility Use Application Pools (City of Winchester)

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Completed 5 August 2020

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