Cornwall Hill Ballfield Rental Rates Application Form
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1
2TOWN OF PATTERSON
Director of
RECREATION CENTER
Recreation & Parks
Matthew Chibbaro
PO Box 278
65 Front St
Patterson, New York 12563
(845) 878-7200 Fax (845) 878-7232
www.
APPLICATION FOR USE OF CORNWALL HILL ROAD BALLFIELD
In order to consider your request for the use of the Facilities, please complete the following information and mail to the
Patterson Recreation Center, Attn: Scheduling Director, P.O. Box 278, Patterson, New York 12563. Please submit this
application at least one month prior to the start of the season.
TO BE COMPLETED BY THE APPLICANT
ORGANIZATION: ____________________________
DATES OF USE: _______________________
NAME: _____________________________________
DATE OF APPLICATION: _______________
ADDRESS: _________________________________
SEASON: FROM: _________TO: __________
PURPOSE: _________________________________
PHONE: _____________________________
CELL: _____________________________________
EMAIL: ______________________________
INSURANCE INFORMATION
APPLICATION MUST HAVE CERTIFICATE OF INSURANCE ATTACHED
Do you (the requesting applicant); have an in-force General Liability Policy? ________________________
If yes, what are the limits of liability? Bodily Injury $________________ Property Damage $__________
Please provide a copy of Certificate of Insurance: the Certificate should name the Town of Patterson as an Additional
Insured. If the applicant hires an outside vendor i.e., caterer, etc., the vendor must provide the Town with a copy of a
Certificate of Insurance, which indicates coverage for General Liability, including Products and Completed Operations
coverage, and Worker’s Compensation for their employees. The vendor policy should also name the Town of Patterson
as an Additional Insured.
RULES FOR THE USE OF THE CORNWALL HILL ROAD BALLFIELD
Permits must be completed and approved by the scheduling director prior to use of the field.
The availability of the field will be on a first request basis.
Completed permits include all necessary information.
A 50% Rental deposit required 30 days prior to the start of the season. Balance due on the last day of the season.
REFUNDS WILL ONLY BE ISSUED DUE TO INCLEMENT WEATHER. NO REFUNDS WILL BE ISSUED DUE
TO FORFEITS/GAME CANCELLATIONS.
Teams are responsible for getting the field ready themselves. As part of the rental, equipment to do so will be
provided to the teams. TEAMS ARE RESPONSIBLE FOR ANY EQUIPMENT DAMAGED DURING THEIR USE.
No alcoholic beverages will be permitted on Town property.
A valid insurance policy will be required prior to any approval of permits. Policy requires groups to have
$1,000,000 worth of liability insurance naming the Town of Patterson as an additional insured.
Un-expired
insurance certificates must be submitted when approval is granted and prior to use of the facilities.
A signed Agreement to hold the Town of Patterson harmless against any liability will be required.
Games involving children must be properly chaperoned.
Violations of these rules will result in the loss of the 50% deposit as well as being charged with the outstanding
balance. Possible legal action may be taken toward the parties involved as well as the possibility of being banned
from future use of, and participation in, recreation facilities and events.
Use of the recreation facilities will not be approved if the individual or group has an outstanding balance due from
previous use.
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