Fillable Park Application Form 2012

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Park Application Form 2012

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File type: PDF

U.S.A. forms for Town of Fishkill

BROWSE TOWN OF FISHKILL (NY) FORMS

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Updated 3/9/2012
TOWN OF FISHKILL
793 Route 52 * Fishkill, New York 12524
______________________
(845) 831-3371 * Fax (845) 831-3069
PARK PERMIT DIRECTIONS
1. Fill out the two Forms below by typing in the shaded areas
2. When finished save it to your computer’s hard drive.
3. Email the completed form as an attachment to Jay Maietta of the
Fishkill Recreation Center at jmaietta@fishkill-ny.gov
4. Your request will be reviewed for approval and you will be notified
whether it has been approved or denied via email.
5. If you are having difficulty you may print the form and fax it to
845-831-3069.
Updated 3/9/2012
APPLICATION FOR THE USE OF FACILITIES
(Submit the completed form at least thirty days prior to the event)
Name of Organization (Please print)
Contact Person (Please print)
Mailing Address
Telephone Information (Day) (Night (Cell)
Description and Purpose of Activity Planned
Estimated Number of Persons in Attendance
Person in Attendance & Responsible for Supervision
Address Phone
DATES BUILDING OR GROUNDS ARE TO BE USED
(If the use is for an extended period, indicate start and end dates)
Name of Building/Park Room(s)/Field Desired
Day(s) of the week requested
Date(s) requested
Arrival/Departure Time Requested
Please note use of town facilities when not otherwise in use may include custodial/police overtime fees, set up and clean up fees.
FOR TOWN USE ONLY
Custodial Overtime Hourly Rate Facility Use Fee(s)
_______________
Estimated Personnel Needed for Event Total Estimated Overtime Hours _______
Facilities Manager Signature___________________________ Date:
Recommended by____________________________________ Date
Department Head
Approved by _______________________________________ Date _____________________
Supervisor Signature _________________________________ Date _____________________
Updated 3/9/2012
PARK PERMIT APPLICATION
PLEASE ATTACH COPY OF INSURANCE CERTIFICATE
Use of the Park requires an Insurance Certificate in the amount of $1,000,000.00 listing the Town of Fishkill as
additionally insured
CONTACT INFORMATION:
Name of Organization:
Name of Applicant:
Street Address:
City: State: Zip: Fishkill Resident: Yes: No:
Day #: ( ) - Ext: Home#: ( ) -
Cell #: (
)
-
Email:
__________________________________________________________________________________________________
PLEASE SELECT WHICH FACILITY YOU ARE REQUESTING:
Proposed Activity or Occasion?:
Which Park(s) are you requesting?
Geering Park
Doug Phillips
What Facilities do you need for your event?
Pavilion
Basketball Court
How many Courts? 1 2
Tennis Courts
How many Courts? 1 2 3 4
Ball Field
How many Fields? 1 2 3 4
Field Size? Softball Little Lg Baseball Senior/Major Lg. Baseball
DATES REQUESTING:
# of Dates Applying for:
Dates and Times Applying for: (Please see following page if additional Dates are needed.)
Date
Time
Estimated # of People
FOR OFFICE USE ONLY:
Request to LL _____ Calendar Tentative _____
Request Approved _____ Request Denied _____ Calendar Updated _____
Paid _____ CK # _____ Deposit _____ CK # _____
Permit Issued_____ Bathroom Key Issued _____ 331 Key Issued_____ Tennis Key Issued_____ Bases Issued _____
Bathroom Key Returned _____ 331 Key Returned_____ Tennis Key Returned_____ Bases Returned _____
Updated 3/9/2012
ADDITIONAL DATES REQUESTING:
Dates and Times Applying for: (Please see PAGE 2 if additional Dates are needed.)
Date
Time
Estimated # of People
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Park Application Form 2012

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Completed 12 July 2020

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