William R. Talley Rec Center
121 North Bentz Street
Frederick MD 21701
Date of Application:
Date Received:
Date of Approval:
Date of Issuance:
Type of Permit:
301-600-1493
FAX: 301-600-2849 www.cityoffrederick.com APPLICATION FOR USE OF CITY PARKS
(Revised 7/2013)
Applications & payment are due at least ten (10) days prior to the event unless otherwise noted.
PAYMENT IS REQUIRED WITH APPLICATION SUBMISSION AND WILL NOT BE ACCEPTED WITHOUT IT.
PLEASE READ AND COMPLETE ENTIRE APPLICATION PRIOR TO SUBMITTAL.
FAILURE TO COMPLETE ENTIRE APPLICATION WILL RESULT IN DENIAL OF REQUEST.
Please call with any questions!
Organization:
Contact Name:
Mailing Address:
Email Address:
Daytime Phone:
Evening Phone:
Cell Phone:
PARK REQUESTED:
Date of Event (Day of Week / Month / Date / Year):
Start Time of SETUP for event:
Stop Time for completion of TEAR DOWN:
am / pm am / pm
EVENT Start Time:
EVENT Stop Time:
am / pm am / pm
Name and Complete Description of Event*:
*If Yard Sale, additional fee applies.
Will entertainment be involved?:
If yes, give details w/# of groups, type of music, time of performance(s) etc.
See Noise Ordinance, Sec. 15-21.
Will other equipment be used?:
Any entertainment will need the approval of the Parks & Recreation Commission and City Police Department
– allow forty-five (45) days for approval.
Live Band(s)
Yes
DJ
Radio/CD Player
Other:
No
(i.e. generator, tents, inflatables, etc.)
If yes, give details.
Certificate of Insurance may be required.
Will vendors be at the event?:
If yes, give details.
Is this a parade, walk or run?:
If yes, give details.
Will participants be charged a fee?:
Organizer must contact the Building Dept at 301-600-3814 for a Vendor/Peddler Permit. Fees apply.
Yes
No
Organizer must contact the Recreation Department at least 90 days prior to the event at
301-600-1493. Fees apply and other paperwork required.
Yes
Yes
No
No
Yes
No
If yes, provide detailed budget of the proposed activity.
Will admission be charged to the event?:
If yes, what is the cost?
Number of people expected to attend:
Name & contact info for two (2) people with authority present during the event:
Check any City assistance needed:
If available; note that not all parks have these amenities.
Indicate other areas of the park to be used:
*Additional fees apply.
less than 50
51 - 100
101 - 150
more than 150
If over 150 people, considered “event” – will require Parks & Rec Commission approval.
Name:
Phone:
Name:
The City of Frederick / Parks & Recreation Department
WAIVER AND FACILITY PERMIT
It is hereby agreed and understood that the above Facility is reserved, as specified, for the use of the above named person and/or User. The Facility reserved is subject to inspection by any authorized representative of The City of
Frederick in order to assure proper use of City property. This permit must be in the possession of the User to whom it is issued and shown upon request to any of the above-mentioned representatives.
The user assumes personal liability and responsibility for any and all costs of cleanup of the premises, loss, breakage, damage to or removal of City property and further assumes liability and responsibility for the conduct and good order of the group and its invitees and guests.
The User shall be responsible for any and all loss, damage or injury to any and all personal property that it or its agents, representatives, invitees or guests, may bring to, store at, or leave at the Facility, and shall indemnify and hold harmless The City of Frederick and any department, agent, official and/or employee thereof for any personal injury incurred during, or as a result of such use. The User further agrees to abide by all procedures, policies, and rules governing use of the
