Agenda - Council - 09/27/1994 - Laserfiche WebLink

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Facility Date requeste~ Est. number Organization CITY OF RAMSEY FACILITY USE PERMIT group Function Time-Indoor Time-Outdoor Phone Res. Phone Address _ , Verified Non-Res.~ Leader in ChaNge, Is this a youth group? Yes No If so, what is ybur percentage of resident and not-residents participants. Please provide ~ list to verify. % Ramsey % Other Will participate, on in this activity be restricted in any way on the basis of sex, race or religious affiliation7 ~es. No If yes, what restrictions? ! Fees must be paid at time of application LOCATION~ FEE KEY Building Shelter . Field/Court Field/Court w/liih t~ Damage Deposit'"t- $75.00 (resident and non-resident) Key Deposit - $1 5.00 per key (resident and non-resident) TOTAL FEE Date paid. Key returned I, the Permit Use~(s), have read and understand the Policies and Procedures for Park/Facility Use as printed on the l~ack of this form and further agree that the5, shall be strictly observed and accept responsibility forithe enforcement of them. In consideration of acceptance, I, the user(s), waive and release any apd all fights and claims for damages against the City of Ramsey and agree to protect, indemnifj, and hold harmless the City and its officers and employees from any and all claims, liabilities, ldamages or rights of action (directly or indirectly) while participating or using the facilities covered by this permit. Signature of RespO~nsible Person Date: Park Department INDOOR Date of App. Res. Nbn-Res. Date issued File number (FOR OFFICE USE ONLY) OUTDOOR Date of App. Res. - Non-Res. Date issued File number