CITY OF PEEKSKILL USE OF RIVERFRONT GREEN APPLICATION APPLICATION INSTRUCTIONS 1. The following must be returned to the Recreation office to have your permit considered for approval: Completed and signed Use of Riverfront Green Application Appropriate fee paid by cash, personal check or money order Deposit paid by cash or check dated for the day of your event Please make checks payable to City of Peekskill 2. You may return your completed Application packet in person to the Recreation Office Monday through Friday between the hours of 9:00 am and 4:45 pm. You may mail the completed packet to: Peekskill Recreation 1 Robin Drive Peekskill, New York 10566 3. Alcohol (beer and/or wine) may not be served without an approved Alcoholic Beverage Permit. If you are planning to serve alcohol at your event you must complete an Alcoholic Beverage Permit Application and submit it with your packet for approval with a $125.00 fee and a copy of your Driver s License. 4. Upon approval, an approved copy of the Park Use Application will be mailed to you. Please bring it with you on the day of your event. 5. A valid Certificate of Insurance (for all organizations and groups with 50 or more guests) must be provided no later than 2 weeks before your event. Forfeiture of fee, deposit, and permit will result from not providing a Certificate of Insurance less than 2 weeks prior to your event. 6. Be advised that your reservation is not finalized until all completed paperwork is received along with your fee, deposit and certificate of insurance (if necessary), and approved. The City of Peekskill s events take precedence and the City has the right to cancel/reschedule any approved events as needed. 7. As long as the permittee was in compliance of all rules and regulations your deposit will be returned to you by mail after your event. Cash deposits may be picked up at the Recreation office with proper identification. 8. Refund Policy: Refund requests must be made in writing no later than 2 weeks prior to your event. Refunds will be issued ONLY if the City is able to rent the space for that day. FORFEITURE OF DEPOSIT MAY RESULT FROM ANY OF THE FOLLOWING: a. Failure to comply with the Park Use Requirements b. Failure to leave the area in clean condition c. Having the amount of guests in your party exceed the number on your application d. Having more than 49 guests in your party without a Certificate of Insurance -1-
CITY OF PEEKSKILL USE OF RIVERFRONT GREEN APPLICATION Today s Date Date Requested Purpose of use: Hours of use (City parks close at dusk) to Total number of participants expected Will alcohol be served? No Yes (a separate Alcoholic Beverage Permit must be submitted) Hours for amplified sound (2 hr. limit) to Amplified sound is sound that is audible (25) feet from the device. FEE SCHEDULE (RAIN OR SHINE NO REFUNDS) Residents*: 49 people & under $ 125.00 Non-Residents: 49 people & under $ 250.00 50 100 people $ 250.00 50 100 people $ 500.00 Over 100 people $ 700.00 Over 100 people $1,000.00 *A Resident is defined as a person who is a resident elector in the City of Peekskill. A separate $100.00 deposit (cash or check dated for the day of your event) is required. Name: Address: Organization: Supervisor: Home Phone: Cell: AGREEMENT The undersigned is over 21 years of age and has read this form and attached regulations and agrees to comply with them. He/she agrees to be responsible to the City of Peekskill for the use and care of the facilities. He/she, on behalf of does hereby covenant and agree to defend, indemnify and hold harmless the City of Peekskill from bodily injury and/or property damage, to the extent permissible by law, arising out of or in connection with the actual or proposed use of City of Peekskill property, facilities and/or services by. Signature / Organization s Representative Address: Phone: FOR OFFICE USE Approved Rejected Fee Paid Check # Rec d by Deposit Paid Check # Rec d by Cert of Insurance Rec d by Deposit Returned Signature of Authorized City Representative Date Copies to: Date Sent Initials Police Dept. DPW Permittee
The use of all Recreational and Park facilities shall be subject to the approval and rules of the City of Peekskill. The City of Peekskill recognizes that the City Parks belong to the people of the City, maintained and operated by funds provided by local taxes. The City recognizes and accepts the responsibility for making the facilities available to responsible individuals, organizations and associations. FAILURE TO COMPLY WITH THE BELOW LISTED REQUIREMENTS WILL RESULT IN THE FORFEITURE OF THE PERMITTEES DEPOSIT. 1. Persons wishing to use municipal Park facilities shall first apply to the Recreation Department on the prescribed form. The City Manager, or authorized designee has final authority of approval. 2. The City of Peekskill Recreation Department does not offer rain dates or refunds in the event of inclement weather. 3. An application for a Park Use Permit for any Peekskill Park must be submitted for approval to the Department of Recreation at least 2 weeks prior to the date of use. 4. The fee for use and deposit are payable at the time of booking. Once a reservation fee has been paid in full, and the deposit received, the reservation has become finalized. 5. The Permittee receiving a Park Use Permit agrees to and acknowledges the responsibility for compliance with all applicable rules, regulations, ordinances, and statutes. The Permittee expressly agrees that they will not use the Park Facility to which the permit applies for any activity proscribed by the laws of the U.S., State of New York, the County of Westchester or the City of Peekskill. The Permittee further agrees to accept the total responsibility of preserving proper order and decorum, the protection of City property, and the restoration of the facility to the condition in which it existed prior to the event. The Permittee agrees to comply with the instructions and directions of the City Manager or his authorized designee and all City of Peekskill staff. The commission of any act in violation of Federal, State, Count, or local laws by the Permittee shall be deemed a material breach of the terms of the Park Use Permit and shall be sufficient grounds for the Permittee s Park Use Permit to be revoked as well as license to use City Park Facilities granted therein. 6. All posted rules must be adhered to. Failure will result in forfeiture of deposit. 7. FORFEITURE OF DEPOSIT MAY RESULT FROM THE FOLLOWING: Failure to comply with the Park Use Requirements Failure to leave the area in clean condition Having the amount of guests in your party exceed the number on your application Having more than 49 guests in your party without a Certificate of Insurance 8. Any damage to municipal facilities shall be promptly repaired at the user s expense. NO EXCEPTIONS. 9. Permittee using the facilities must clean up afterwards. 10. Alcohol is allowed only by permit. A separate $125 fee is required for an Alcohol Permit. 11. No canopies, tents or other equipment may be erected by the Permittee in any City of Peekskill Park unless authorized. 12. No gas grills are permitted in any City of Peekskill Park Facility. -3-
13. Profanity, objectionable language, disorderly acts or illegal activities of any kind are absolutely prohibited, and those violating this prohibition will be ejected from the premises and will forfeit their deposit. 14. The use of radios, or other audio devices, including care radios, in such a manner that such devices are audible at a distance of more than twenty-five (25) feet from such device is prohibited. IF REQUESTING APPROVAL OF AMPLIFIED SOUND: Amplified sound is LIMITED to two (2) hours for Park Use Permit. 15. Parking shall be limited to those areas designated by the City Manager or his authorized designee. Parking on the grass is not allowed. 16. The City in its discretion may impose additional requirements prior to the issuance of this permit as required by the nature of the use applied for. 17. Permits may be revoked at any time. 18. Any usage with youth (age 17 & younger) requires the presence of adequate adult supervision at all times. 19. In the event of an emergency the Permittee must contact the Peekskill Police by dialing 911 or calling 914 737-8000. 20. In the event of an accident, please notify the Recreation Office at 914 734-7275 the next business day. 21. Refund Policy: Refund requests must be made in writing no later than 2 weeks prior to your event. Refunds will be issued ONLY if the City is able to rent the space for that day. 22. The Permittee hereby assumes all risk for damage and defacement of City property, and agrees to indemnify the City for damage resulting in bodily injury to any and all persons arising of the use of the premises for which the Park Use Permit is granted, and agrees to indemnify and hold harmless the City of Peekskill, and its departments, officers, employees and agents from any and all claims, suits, losses, damages, or injuries to persons or property where arising directly or indirectly out of the use of the Park Facility for which the permittee shall execute a written instrument setting forth its agreement to indemnify the city as aforesaid. 23. For all Organizations and groups of 50 persons or more, users must provide the following insurance prior to using facilities. FAILURE TO DO SO 2 WEEKS PRIOR TO USE WILL RESULT IN REVOCATION OF YOUR PERMIT AND FORFEITURE OF YOUR DEPOSIT AND FEE. The Permittee shall obtain the following insurance coverage from an insurance company, approved by the City Manager or his authorized designee, licensed to do business in the State of New York. Said insurance shall remain in effect for the duration of the event for which the Special Use Permit is issued. -4-
Insurance Requirements Organizations: A. The user hereby agrees to effectuate the naming of the City of Peekskill as an unrestricted additional insured on the user s policy. B. The policy naming the City of Peekskill as additional insured shall: Be an insurance policy from an A.M. Best rated secured New York State licensed insurer; Contain a 30 day notice of cancellation; State that the organization s coverage shall be primary coverage for the City of Peekskill, its Board, employees and volunteers; and Additional insured status shall be provided with ISO endorsement CG 2026 or its equivalent. C. The user agrees to indemnify the City of Peekskill for any applicable deductibles. D. Enclose a copy of the endorsement providing additional insured status. E. Required Insurance: Commercial General Liability Insurance $1,000,000 per occurrence/$2,000,000 aggregate. F. User acknowledges that failure to obtain such insurance on behalf of the City of Peekskill constitutes a material breach of contract and subjects it to liability for damages, indemnification and all other legal remedies available to the City of Peekskill. The user is to provide the City of Peekskill with a certificate of insurance, evidencing the above requirements have been met. The failure of the City of Peekskill to object to the contents of the certificate or the absence of it shall not be deemed a waiver of any and all rights held by the City of Peekskill. Individuals: (groups of 50 or more) Required Insurance: Homeowners Insurance Section Two Liability: $500,000 limit of liability. Policy shall exclude the off-premises activities of the insured. I certify that I am an authorized representative of this organization and that these statements are true to the best of my knowledge. I have read and received a copy of THE PARK RULES, and I and/or the organization I represent agree to be bound by all applicable regulations and policies. I and/or the organization I represent understand that any violation of any of these will result in denied use of the City Facilities in the future. I and/or the organization I represent agree to pay all reasonable costs for damage and/or vandalism to the Park or Facilities used in relation to the event. Signature Date -5-