City Use Govt Agency Private Commercial Non-Profit
Estimated Number of Attendees Special Event Permit Issued
Please check all applicable areas of use for your event:
CA 3.2.17
DATE RECEIVED:
Applicant:
Phone/Cell:
Email:
Address:
PARK USE PERMIT
Lake Havasu City Aquatic/Recreation Division
100 Park Avenue • Lake Havasu City, AZ 86403
Phone: (928) 453-8686 FAX : (928) 453-1133
Event:
Applicant's Signature: Date:
FOR OFFICE USE ONLY
Total Due:
Cash/Check/Charge:
Date:
Receipt #:
Approved by:
Start/End Time:
Will your event include music?
Will your event include alcohol consumption?
Date(s) of Use:
(Contact Name):
City, State, Zip:
(Groups over 100 require Special Event Permit turned in at least 30 days prior to event)
YES
(Group Name):
(No alcohol at Jack Hardie Park, no glass in all parks)
YES
NO
NO
NO
NO
YES
YES
Please note, we do not take reservations for volleyball or basketball courts at London Bridge Beach or bocce ball
courts or firepits at Rotary Community Park. Use of these facilities are on a first come, first served basis.
To the fullest extent permitted by law, Applicant agrees to indemnify, defend, save, and hold harmless Lake Havasu City, its departments, agencies,
boards, commissions, officers, officials, agents, volunteers, and employees (“Indemnitee”) for, from, and against any and all claims, actions, liabilities,
damages, costs, losses, or expenses (including, but not limited to, court costs, attorneys’ fees, and costs of claim processing, investigation and litigation)
to which any Indemnitee may become subject, under any theory of liability (“Claims”) to the extent that Claims are caused by the negligent acts,
recklessness, or intentional misconduct of the Applicant arising out of or as a result of use of a park. Applicant agrees to be responsible for primary loss
investigation, defense, and judgment costs where this indemnification is applicable.
Please give a brief description to any "Yes" answers above:
Will your event set-up equipment, i.e. air bounce, etc.?
Rotary Community Park
London Bridge Beach
Jack Hardie Park
Grass Area
(No water slides, bounce houses, or staking in grass)
Beach/SandVolleyball Court #Ramada(s) #
Applicant acknowleges and agrees to the following rules and regulations:
General Park Rules:
Rev. 1/4/17
All parking is on a first come, first served basis; we do not reserve parking spaces.
The City parks have been improved for your enjoyment. We ask for your assistance in keeping them
clean and safe for everyone's use.
Lake Havasu City Aquatic/Recreation Division
Thank you for your cooperation,
signs for vehicle use. No vehicles are allowed on grass, sidewalks, or maintenance roads.
Motorized vehicles must remain on maintained roadways, parking areas and areas designated by
permission from the City.
No person shall sell or offer for sale any food, wares or merchandise in the park without written
NO OVERNIGHT MOORING on the beach.
NO MOTORHOMES allowed in Rotary Park with exception of Park Host.
NO BOUNCE HOUSES or SLIP 'N SLIDES on grass areas.
NO ALCOHOL allowed in the park unless disclosed on approved permit.
NO LAUNCHING or RETRIEVING of any motorized watercraft from beach.
NO DOGS or PETS allowed in Rotary Community Park.
NO CAMPFIRES allowed except in barbeques or approved containers.
NO GLASS CONTAINERS allowed in any City park.
Applicant shall be responsible for clean-up and restoration of the area used and
shall be fiscally responsible for any damage incurred during use.
Applicant shall be responsible for all members of his/her group and shall ensure that all park
rules and regulations, state laws, and all other provisions of this reservation are met.
All activities specified or permitted under this reservation shall be conducted under appropriate adult
supervision.
Receipt shall be shown upon request by any City official.
LAKE HAVASU CITY WELCOMES YOU
Applicant shall retain a copy of the receipt and have in possession the day of use.
This reservation is non-transferable.
This reservation shall remain in effect only during the date and time shown on the receipt.