Fillable Clifton Recreation Equipment Rental Request Form printable pdf download

CLIFTON RECREATION DEPARTMENT

900 CLIFTON AVENUE

CLIFTON, NEW JERSEY

PHONE: (973) 470-5956

FAX: (973) 815-0599

CLIFTON RECREATION EQUIPMENT RENTAL REQUEST

(You must complete a separate application for each date requested)

Date Requesting: _______________________

Date Returning: ____________________________

Approximate Time of Pick Up: ____________

Approximate Time of Return: _________________

Requestor (Group/League/Company): _____________________________________________________

Contact Person: ___________________________ Intended Use: ______________________________

(i.e.: picnic, school function, etc.)

Address: ____________________________________________________________________________

City: ________________________________

State: ___________ Zip: ____________________

Home Phone #: _______________________

Cell Phone #: ______________________________

Work Phone #: _________________________

Email: ____________________________________

Equipment/Supplies Needed:

Picnic Basket

Volleyball Net

Bocce

Horseshoes

Badminton

Croquet

Tables

Chairs

_______

______

(number)

Other: ________________________

Additional Information Concerning Rental:

The equipment requestor/organization listed above certifies that he/she has received and read the accompanying Equipment Use Rules and Regulations of

the City of Clifton/ Recreation Department and agrees to comply with all the rules governing the use of the equipment. The facility requestor/organization

agrees to accept full responsibility for any damage incurred during use and will ensure that the equipment is returned in a clean, safe and orderly condition.

Should the City of Clifton have to repair or restore any of the equipment, fees will be charged to the facility requestor/organization to whom permission for

use has been issued for the remediation of said equipment. The facility requestor/organization is responsible for the conduct of all participants using the

rental equipment to assure that it is used in the manner in which it was intended.

The facility requestor/organization agrees to indemnify and hold harmless the City of Clifton and its officers, agents, employees, volunteer or other

representatives from any and all liability, claims, costs, professional fees or other expenses or liabilities arising out of the use of the equipment, owned by the

City of Clifton, referred to above.

I understand that this Hold Harmless Agreement also requires that the City of Clifton is indemnified from any losses or damages resulting from the acts or

omissions from any guest/participants who use the above listed equipment.

Applicant’s Signature: __________________________________ Date: ___________________

----------------------------------------------- Office Use Only -----------------------------------------------

□

Received Payment

Marked on Calendar

Prepare Equipment

Received: __________________________

□

Check Equipment

Return deposit

Approved: __________________________