Fillable of Wood Village Donald L. Robertson City Park (City of Wood Village)

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of Wood Village Donald L. Robertson City Park (City of Wood Village)

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BROWSE CITY OF WOOD VILLAGE (OR) FORMS

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Permit No._______________
City
of Wood Village – Donald L. Robertson City Park
ONE-DAY FACILITY USE PERMIT
NAME __________________________________________________________
ADDRESS__________________________________________________________________
CITY_________________________________ STATE____________ ZIP________________
PHONE _____________________________ ALT. PHONE____________________________
EMAIL _____________________________________________________________________
TOTAL NUMBER OF GUESTS (INCLUDING SPECTATORS): _______________________
Which Facility are you Renting:
Athletic Fields NE Field SW Field Picnic Shelter Gazebo
Requested Date: Month __________Day ________Year _______________
Start Time________________ End Time_______________ Total Number of Hours_______________
Notes/ Special Requests:
FEES
Group of 100 or less in size, $0 Permit Fee
Large Group 101 or more in size, $100 Permit Fee, and
Security Deposit, amount determined case-by-case basis
Facility Attendant, actual cost
Insurance required with a limit of $2,000,000 and City of Wood Village named “additional insured”
Commercial Event, $500 Permit Fee
Security Deposit, amount determined case-by-case basis
Facility Attendant, actual cost
Insurance required with a limit of $2,000,000 and City of Wood Village named “additional insured”
All permit fees are required at time of permit request. All other fees and proof of insurance are due 30
days after permit request has been granted
One-Day Park Facility Use Permit
Page 2
General Rules of Use:
Alcohol and/or drugs including cigarettes and tobacco products are not permitted within park
No food or drink in the Tot Lot
Music and Amplification - separate application required
Trash Pick-Up: police your area clean and place trash in proper receptacles
All dogs must be kept on leash and owners need to be prepared to clean up waste (Leash and Scoop)
Special Requests, e.g. Tents, Banners, Entertainment, etc. need to be submitted at time of permit
request
Camping is prohibited
No overnight parking
No changes are to be made to the fields without prior notification and approval by the City
Example: home run fence
Report vandalism to City Hall
User is responsible for the posting and enforcement of the reservation
Any applicant that fails to follow the above rules may be removed from the park, and in addition will
forfeit their security deposit and may have future permits revoked.
Hold Harmless Agreement
The Permittee shall indemnify, defend, and hold harmless the City of Wood Village, its officers,
agents and employees from any and all claims, suits, or actions of any nature resulting from or
arising out of the activities of the Permittee, its officers, employees, agents, members, or invitees.
The Permittee shall be financially responsible for any damages to the park facilities resulting
from its use of the facilities. The undersigned certifies that (s)he is authorized to execute this
permit on behalf of the Permittee. I have also read and agree that I/my organization will abide
by the rules and guidelines established by the City of Wood Village for field and facility use.
Signed_______________________________________ Date__________________________
For City Use Only
Fee Paid $_________________________ Date Paid_______________ Receipt #__________
Comments:____________________________________________________________________
_____________________________________________________________________________
Received by _______________________Date__________ Approved by________________
Signed and dated Certificate of Insurance on file/ (circle) Yes No N/A
Insurance Policy Number:_________________________
Company:______________________________________
Revised March 18, 2013
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Completed 17 July 2020

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