COLEBROOKDALE TOWNSHIP LIBERTY PARK

APPLICATION FOR RESERVATION OF PAVILION/PICNIC AREA

809 N. Reading Avenue, New Berlinville, PA 19545

Name______Phone______

Address______

______Date Requested______

TERMS AND CONDITIONS:

A rental charge of $40.00 per day for Township residents and $65.00 per day for non-residents shall be imposed upon the person/party requesting to use the pavilion located in the public recreational area owned by the Township of Colebrookdale and commonly known as “Colebrookdale Township Liberty Park”. In addition, a security deposit of $25.00 must be paid to the Township. Said security deposit shall be held by the Township and will be returned to the person/party using the pavilion after the date of said person/party’s use of the pavilion if the pavilion is returned in a clean condition. All trash must be removed from the premises by the person/party who used the pavilion, all horseshoe and/or quoits pits must be filled in and the restroom key must be returned to the Township Office. Any violation of the park rules/regulations will result in forfeiture of the security deposit.

Both the rental fee and security deposit must be paid to the Township at the time the request to use the pavilion is approved by the Township. The restroom key must be picked up at the Township office between the hours of 8:00 AM and 4:00 PM Monday – Fridayno earlier than one week prior to the date of reservation.

RULES AND REGULATIONS:

1.Park Hours – 9:00 a.m. to Dark.

2.No one (children or adults) is permitted on the stage.

3.No Pets Allowed anywhere on the pavilion/picnic grounds.

4.Positively NO ALCOHOLIC BEVERAGES ALLOWED

5.No digging open pits for fires or games.

6.Electrical outlets provided. Charcoal and propane grills are permitted for cooking.

7.Water faucet is located on the outside of the front building.

8.Clean up area after use (see above security deposit terms).

9.Persons defacing, destroying or littering the property are subject to a fine.

10.The Township of Colebrookdale assumes no risk or liability for loss, theft,damage or injury to any person(s) or personal property associated with theuse of this facility.

THIS IS YOUR PARK ~ PLEASE KEEP IT CLEAN

With the terms and conditions agreed upon and understood, the Township of Colebrookdale hereby grants a permit for the use of the pavilion/picnic area on the above date between the hours of 9:00 a.m. and dark. Should any problems arise, call one of the following Township personnel:

Mike Hillegas ~ 484-332-7207 / Chad Davis 484-300-8023 / Robert Moyer ~ 610-636-4424

Signature of Applicant______Date______Received by______

Deposit: Cash( )Check#_____ Amt. $______Rental Fee: Cash( ) Check #____ Amt.$______

Date Key Given:______Key #______Date Key Returned:______Key #______

Return of $25.00 Depositby______Cash ( ) Check #______