FACILITY USE APPLICATION
Athletic Fields, Gym & Shelter Rentals
EVENT AND FACILITY INFORMATION:
Field / Shelter Requested: ____________________________ Type of Activity: _______________________________
Date: ____________________ Event Hours: Start Time _____________ am/pm End Time ________________ am/pm
Estimated number Participants ____________________
Name: ___________________________________ Phone: _____________________ Email: ____________________________
(Print name of responsible person
Organization Name (if applicable) ______________________________________________________________
Applicants Address __________________________________________________________
City ______________________________ State ____________ Zip __________________
- In the event of inclement weather, refunds will not be granted for shelter rental. Every attempt will be made to reschedule but is not guaranteed.
- All responsible persons must clean up the areas that are being used (site subject to inspection by staff)
- Parking is permitted in designated areas only. No Parking on grass areas.
- Absolutely no alcoholic beverages permitted on Pickens County Properties. Violators will be ticketed.
- Electricity is provided at picnic shelter and fields.
- Use of Bounce House must be approved by Dacusville Recreation. A certificate of insurance for $1,000,000 General Liability from vendor naming Dacusville Recreation as additional insured is required. Bounce houses must have generator and cannot be plugged into electrical outlet. Bounce houses with water features are not allowed.
THE PERSON(S) LISTED ON THIS FORM SHALL BE LIABLE FOR ANY LOSS, DAMAGE OR INJURY SUSTAINED BY ANY PERSON BY REASON OF NEGLIGENCE OF THE PERSON OR PERSONS IN ATTENDANCE. ANY DISCREPANCIES BETWEEN THIS APPLICATION AND THE ACTUAL DATE WILL BE CAUSE FOR FUTURE DENIAL OF FACILITY USE AND ADDITIONAL FEES WILL BE ASSESSED.
I have read and agree to the above facility use application and accept the terms within.
_____________________________________________________________Applicant Name (Please print) Date
FOR OFFICE USE ONLY:
FEE ATTACHED: ___________
PAID (RECEIPT NUMBER) _____________
CHECK __________ CASH _____________
APPROVED BY FACILITIES COORDINATOR: YES_______ NO______