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Name: <br /> <br />Address: <br /> <br />Representing Organization <br /> <br /> CITY OF RAMSEY <br />PARK FACILITY USE PERMIT <br /> <br />Central Park <br />(specify area) <br />other <br /> <br />Tittered Park <br />(specify area) <br />Park Center Building <br /> <br />Date: <br /> <br />Phone (W): <br /> <br />(H): <br /> <br />has permission to use <br /> <br /> facilities on <br /> <br />(date) <br />and <br /> <br />for the purpose of <br /> <br />between the hours of <br /> <br />Special Arrangements: <br /> <br />Fees: $5.00 per day building use <br /> $15.00 key deposit <br /> <br />$200.00 field deposit <br /> <br />Receipt no.: <br /> <br />Receipt no.: <br /> <br />Key returned on: <br /> <br />Receipt no.: <br /> <br />Key no.: <br /> <br /> Initials: <br /> <br />Hours of Use: 7:00 a.m. to 10:30 p.m. <br /> <br />THE USE OF THESE FACILITIES REPRESENTS A PRIVILEGE AND MAY BE REVOKED <br />AT ANY TIME WITH OR WITHOUT PRIOR NOTICE BY THE CITY COUNCIL OR CITY <br />ADMINISTRATOR. <br /> <br />I, the undersigned, have read and understand the Priorities of Use and Rules of Use listed on the <br />reverse side of this application. I understand that a violation of these rules may result in forfeiture <br />of any deposits and additional liability for damages. I also understand that I am responsible to <br />report any vandalism or abuse to the Ramsey Police Department. It is a~eed by the parties hereto <br />that those individuals included in the above group will hold the City of Ramsey harmless for any <br />damages or personal injury incurred as a result of the use of this facility by those individuals. <br /> <br />User Signature: <br /> <br />CITY OF RAMSEY: <br /> <br />Date: By: <br /> <br />FOR CITY USE ONLY: <br /> <br />Park Inspected By: <br /> <br />Date: <br /> <br />Full Refund: <br /> <br />Partial Refund: <br /> <br />Comments: <br /> <br />Copy of permit to: User, Administrative Services, Finance Office <br /> <br /> <br />