Facility Application

Applicant(Required)

Address

Email(Required)

Telephone(Required)

Preferred method of communication

Purpose of Use

Field Requested

Other

Pickleball Court

Date Requested

Time of Activity

Estimated # of people attending

Time of Use

Admission Charged?

Yes

If yes, indicate amount

Proceeds to be used for

Will there be someone certified in AED/CPR present at the event?

Yes

Responsible person in attendance

Telephone (Required)(Required)

Telephone

Date

Do you (the requesting organization); have an in-force public liability policy?

Yes

If no, read and accept Hold Harmless Agreement by entering your name and date.

If yes, what agent & company?

Liability Limit: Property Damage $.

Liability Limits: Bodily Injury $

Attach Certificate of Insurance naming Marshall Community Fund as an “Additional Insured”

Max. file size: 300 MB.

Hold Harmless Agreement

The undersigned agrees that he/she will indemnify and hold free and harmless the Marshall Community Fund from any and all claims or actions for damages or loss to property, including the loss or use thereof, and from any and all claims or actions for personal injury, sickness, or disease, including personal injury, if caused by the undersigned’s acts or omissions, and the undersigned will pay any and all judgement decrees, costs, including attorneys’ fees which may be rendered against Marshall Community Fund, it’s directors, officers, agents and employees, in any and all such actions or proceedings

Name

Dated

I have read the Marshall Park Rules(Required)

Yes, I have read the Marshall Park Rules

CAPTCHA

Use Of Facilities Application

Hold Harmless Agreement

Marshall Park

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