Group
Usage Application
GROUP NAME:______________________________________________________
CONTACT PERSON:__________________________________________________
ADDRESS:___________________________________________________________
_________________________________________________________
TELEPHONE NUMBER:________________________________________________
____10:00AM TO 1:00PM ____2:00PM TO 5:00PM
DATE OF ACTIVITY:____________________
Describe in detail
the activity and in what manner you intend to utilize the facility.
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This reservation well
be issued on the condition that the applicant holds the Town of Fallsburg free
and harmless from any claims for damage arising out of illness, accident,
mischief or any other claim resulting from the consumption of alcohol
beverages, by the applicant and their guests.
I have read and
understand the information noted above and back of this application, and will
be the responsible party organizing the event.
SIGNED:____________________________ DATE:___________________
USAGE FEE $_________
DATE PAID_______________
CASH___
CHECK#__________ RECEIPT#___________
DEPOSIT $________
DATE PAID_____________
CASH___
CHECK#__________ RECIEPT#___________
DATE
RETURNED______________ SIGNED_________________