Fillable PARKS, RECREATION DEPARTMENT FIELD USE APPLICATION PLEASE PRINT (Town of Westford, MA)

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PARKS, RECREATION DEPARTMENT FIELD USE APPLICATION PLEASE PRINT (Town of Westford, MA)

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The PARKS, RECREATION DEPARTMENT FIELD USE APPLICATION PLEASE PRINT (Town of Westford, MA) form is 4 pages long and contains:

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  • 25 check-boxes
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TOWN OF WESTFORD
PARKS, RECREATION DEPARTMENT
PLEASE PRINT
YOUTH USER GROUPS
FIELD USE APPLICATION
ORGANIZATION NAME: _ PERSON IN CHARGE:
ADDRESS:
TOWN:
ZIP CODE: _
BEST NUMBER TO REACH YOU: HOME# _ WORK# CELL #
EMAIL: Additional contact email for field closure notification:
NAME & CELL PHONE # OF PERSON ON SITE
DATE(S) REQUESTED: from
to
TIME OF DAY: _
DAY(s) OF WEEK_
CHECK FIELD SITE(S) REQUESTED
A
merican Legion Field Capt. Stephen Hamilton Field Cameron Field Frost Field
Greystone
Jack Walsh VFW Baseball VFW Softball
Community Fields @Nutting Road Field #1 – front Field #2 – back
SPECIFY FIELD SIZE/ SPACE NUMBER OF FIELDS_
For Primary Users or Multiple uses please submit a seasonal schedule
This permit grants the above-named applicant the non-exclusive right to enter and use certain portions of the Town’s property for the purpose of
conducting recreational activities. I acknowledge that I am solely responsible for ensuring the safety of those using the Town’s property
pursuant to this permit and that I am responsible for ensuring that said use is in accordance with all applicable laws, including but not limited-
to the rules and regulations of the Town of Westford Parks, Recreation & Cemetery Department, and the Bylaws of the Town of Westford.
The permit holder agrees that no person shall be permitted to participate in activities pursuant to this permit unless and until they have executed
the attached Release of Claims, Indemnity and Hold Harmless Agreement.
I understand the Town of Westford By-laws prohibits the use or possession of drugs and/or alcoholic beverages on Town property without
permission and that this permit does not grant said permission.
I certify that a league representative or I will be present at the site during all activities associated with this permit application. I as the
organization representative assume responsibility for the conduct of the group and for the condition of the area upon our departure.
I have read the Standard Conditions and will make players, coaches, league officials, and spectators aware of this information.
SIGNED DATED
Fee Structure: Check one
1. Primary User Groups – up to 50% of annual cost of field maintenance
2. Westford Adult/Westford Business $100/game;
3. Community Fields @Nutting Road: Resident $80/hr, non-resident $120/hr
4. Primary User Alliance, Non-resident youth $100/game
5. Camps/Clinics $1,000/up to 5 days for <50 campers; >50 Additional $10/camper (Jack Walsh)
6. Camps/Clinics $1,200/up to 5 days for <50 campers; >50 Additional $10/camper (Nutting Road)
7. Nonresident Groups (one time use or multiple use) $100/hour/field
FOR OFFICE USE ONLY:
PERMIT:
GRANTED
DENIED
CANCELED
DATE:
SEASON
PAYMENT RECEIVED: CHECK # AMOUNT $ PERMIT #
2020
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STANDARD CONDITIONS
Field Safety Information
1. Coaches must walk the fields and surrounding area prior to use. A potential hazard must be
reported to players, opposing team, and officials. Report hazards within 24 hours to the Parks
and Recreation Director (978) 692-5532 and to League Officials.
2. Serious injury that requires a doctor, hospital, or ambulance shall be reported in writing t
o
th
e Parks and Recreation Department within 24-48 hours. Report forms are available from
the department and on-line
3. Closed fields may not be used for any reason. Use of a closed field jeopardizes the safety of
all and will require additional maintenance to restore the field to safe conditions.
4. A field that is saturated (water logged and feels like walking on a wet sponge) or has standing water
in the playing area should be closed by coaches to avoid damage. If a footstep leaves an
impression on the turf, or if the grass is removed easily with a cleat, the field is considered wet and
should be close until conditions change.
5. Frost on the field – field should not be opened until frost has melted.
6. Fields should be closed under any of the following conditions: lightening, heavy rain/downpour
of rain, thunder, or severe weather warnings, other conditions that present safety concerns for
users/spectators.
7. Field is frozen = field closed
8. Field should be closed when the footing is unsure and or slippery.
9. Coaches and leagues are not allowed to do any maintenance work on wet fields. Do not brush water
off water/clay onto grass areas. This creates a major and unnecessary problem maintaining the
grass around the base areas. The clay settles in the grass creating an uneven base path or lip
resulting in a potential tripping hazard.
10. Soft toss/batting practice and/or kicking against fences is not allowed.
11. Trash and Recycling
Upon completion of a game or practice, the group/team coaches are responsible for the proper
r
emoval and disposal of trash associated with their use of the property. All fields and benc
h
ar
eas should be left clean at the end of each use
.
12. Blocking of Emergency Access entrances is strictly prohibited.
13. COMMUNITY FIELDS AT NUTTING ROAD
• Due to the nature of synthetic turf and its recovery ability the Community Fields at
Nutting Road may stay open when the grass fields are closed. They will be closed i
f
s
now covered and permit holders are not allowed to remove snow from any field. The
field is closed with standing water until it has drained, and surface has dried.
• No beverages /drinks other than plain water allowed on the synthetic turf fields
• No food is allowed on the synthetic turf fields
• No dogs allowed on synthetic turf
• No chewing gum or similar substance is allowed as gum may damage the synthetic turf.
• No staking of any object into the synthetic turf.
14. All the recreation fields are located in residential areas. Please be respectful of neighbors and the
neighborhood.
Completed Forms can be sent via email, fax, mail or hand delivered using the following contact information:
Westford Parks & Recreation Department, 65 Main Street- 3
rd
Floor, Westford, MA 01886
JFelicani@WestfordMA.Gov
Fax: (978) 392-4471
CHECK LIST
FIELD PERMITS APPLICATION REQUIREMENTS
____ COMPLETED & Signed Field Permit Application
____ ATTENDEE ROSTERS
____ WAIVER RELEASE FORMS per each participant
____ SUBMIT PAYMENT
Release of Claims, Indemnity and Hold Harmless Agreement
I,
, in consideration of the opportunity to participate in a sporting
event or other recreational activity at the Town’s fields (the Program), do hereby release the Town of Westford, and
any employees, agents, officials, representatives, officers, committees, boards, members, sponsors, agents,
associates of any status, and volunteers of the Town of Westford, of any and all liability for any and all claims,
actions, causes of action, demands, damages, costs, loss of services, expenses and compensation which I may have
as the result of my participation in the Program and all activities related thereto. I further acknowledge that
participation in the program is voluntary and may expose me or my property to risks of personal injury. I therefore
enter this program assuming all risk of injury to my person or property arising from my participation in the Program,
and in this regard, assume and agree to pay all medical costs or property damage costs occasioned and thereby
releasing the Town of Westford and any employees, agents, officials, representatives, officers, committees, boards,
members, sponsors, agents, associates of any status, and volunteers of the Town of Westford from and against all
claims, damages, injuries or causes of action which I or my heirs, executors, or administrators may have herein.
Furthermore, I hereby agree to protect the Town of Westford and its successors, departments, boards, committees,
officers, employees, servants, attorneys and agents against any claim for damages, compensation or otherwise
arising out of or resulting from any injury to any party in connection with my participation in the aforementioned
Program and to INDEMNIFY, reimburse or make good to the Town of Westford or its successors, departments,
committees, boards, officers, employees, servants and agents any loss or damage or costs, including attorneys’ fees,
which the Town of Westford or its representatives may have to pay if any claims or litigation arises from said
participation in the aforementioned activities.
I h
ereby further covenant for myself, my successors and assigns not to sue the said Town of Westford, or
its departments, officers, employees, servants, attorneys, and agents, on account of any such claim, demand or
liability.
I am fu
lly aware that by signing this document I am releasing the above mentioned parties from liability
that may arise as a result of intentional or negligent acts of these parties. Additionally, it is my intent to release the
above mentioned parties from liability relating to any accident and resulting injuries and/or death that may occur
while participating in the Program.
Witness my hand and seal this day of , .
Program Participant (Signature) Program Participant (Printed)
Witness
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PARENTAL CONSENT, RELEASE FROM LIABILITY
AND INDEMNITY AGREEMENT
I the undersigned father, mother or guardian(s) of , a minor, do hereby consent to
his/her participation in a sporting event or other recreational activity at the Town’s fields (the Program), and
furthermore I do forever RELEASE, acquit, discharge and covenant to hold harmless the Town of Westford, and
any employees, agents, officials, representatives, officers, committees, boards, members, sponsors, agents,
associates of any status, and volunteers of the Town of Westford of and from any and all actions, causes of actions,
claims, demands, damages, costs, loss of services, expenses and compensation on account of or in any way arising
out of, directly or indirectly, all known and unknown personal injuries or property damage which we/I may now or
hereafter have as the parent(s) or guardian(s) of said minor, and also all claims or rights of action for damages which
said minor has or hereafter may acquire, either before or after he/she reaches his/her majority, resulting or to result
from said minor’s participation in the aforementioned Program. Furthermore, I hereby agree to protect the Town of
Westford and any employees, agents, officials, representatives, officers, committees, boards, members, sponsors,
agents, associates of any status, and volunteers of the Town of Westford against any claim for damages,
compensation or otherwise on the part of , a minor, arising out of or resulting from
personal injury to said minor or property damage in connection with said minor’s participation in the
aforementioned Program, and to INDEMNIFY, reimburse or make good to the Town of Westford, and any
employees, agents, officials, representatives, officers, committees, boards, members, sponsors, agents, associates of
any status, and volunteers of the Town of Westford any loss or damage or costs, including attorneys’ fees, the Town
of Westford, its their representatives may have to pay if any litigation arises from said minor’s participation in the
aforementioned Program or administration of first aid.
I hereby further covenant for myself, , our successors and assigns not to sue the said Town
of Westford, or its departments, officers, employees, servants, attorneys, and agents, on account of any such claim,
demand or liability.
I am fu
lly aware that by signing this document I am releasing the above mentioned parties from liability
that may arise as a result of intentional or negligent acts of these parties. Additionally, it is my intent to release the
above mentioned parties from liability relating to any accident and resulting injuries and/or death that may occur
while participating in the Program.
Signature of Parent/Guardian
Date
Relationship
Signature of Parent/Guardian
Date
Relationship
THIS FORM MAY NOT BE ALTERED
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PARKS, RECREATION DEPARTMENT FIELD USE APPLICATION PLEASE PRINT (Town of Westford, MA)

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Completed 5 August 2020

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