City of
Olivette
Parks &
Recreation Department
PARK 9723
Grandview Drive
PERMIT Olivette,
MO 63132
(314) 991-1249
I. FACILITIES
_____ Pavilion _____
Kitchen _____ Football
_____ Soccer _____
Rugby _____ Baseball
_____ Softball _____Lacrosse _____ Volleyball
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II. APPLICANT INFORMATION
Application Date:
_________________ Park Name: _________________
Organization:
_________________________________________________
Name: ______________________________________________________
Address:
__________________________
_________ _____________
Street State Zip Code
Home Phone #:
_______________ Business Phone
#: _______________
Number in Attendance: ________________ Field
#: ________________
Requested Date:
_____________
______________ _____ ______
Day of
Week Month Day Year
Time of Arrival:
________ am/pm Time of
Departure: ________ am/pm
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III. COMPLIANCE WITH LAWS AND FACILITY USAGE
RULES
A
copy of this agreement should be retained and available for presentation in
case of questioning. By signature below
reserve agrees to:
"No
liability, either express or implied, will be incurred by the City, its agents,
servants, and employees, arising out of the use of the premises by permittee,
its agents, servants, employees, assigns, successors, invitees, and licensees,
during the date and time specified above.
Permittee agrees to hold the City, its agents, servants and employees
harmless, and to identify them from and against any and all claims that may be
asserted against the City, its agents, servants and employees, be permittee
(its agents, servants, employees, assigns, successors and invitees and
licensees) including but not limited to reasonable attorneys' fees."
Additionally,
permitte acknowledges receipt of the Olivette Park Rules and Policies attached
as Exhibit
A agrees to fully abide by the rules.
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PERMITTEE CITY
OF OLIVETTE
________________
_____ ________________ _____
Name Date Name Date
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DATE:
____________ RECEIPT: ____________ FEE: ___________
DATE:
____________ RECEIPT: ____________ FEE: ___________
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