CAMPENDOBANAH
c/o 1276 No. 2 Side Road, RR3
Campbellville, ONL0P 1B0
Site Location: ShadowLake
Norland, ON
APPLICATION FOR PERMIT
For use of CampFacilities
- Name of Organization/(“Licensee”): ______
- Address: ______
- Contact Person: ______
- Telephone number: ______
- Aim or purpose of your organization: ______
- Use of Camp space/facilities is requested for the following purpose:
______
- Space/facilities requested: ______
- Date(s) required*: ______
- Expected attendance: ______
- Special Instructions: ______
- Special requirements: ______
The release and indemnity attached hereto as Schedule “A” form part of this application and must be signed prior to the commencement of the use of the space/facilities. If organizational rules do not allow for this form to be signed, a copy of the group’s liability insurance coverage must be provided.
The Rules and Regulations attached hereto as Schedule “B” form part of this application and are accepted in full by the undersigned organization, and the responsibility for damage to Camp property and/or injured person or persons arising from the use or occupancy of the camp space/facilities is admitted and assumed by the organization.
Signature: ______Title: ______
Authorized Signing Officer/Official
I have authority to bind the organization/Licensee
Date: ______
*Once signed, this formis binding for current and all future use of the camp. It is the responsibility of the renter to inform the CampManagement of any relevant changes that affect the information submitted on this form.
SCHEDULE “A”
To:THE BOARD OF TRUSTEES, CAMPENDOBANAH
RELEASE AND INDEMNITY
In consideration of the entry onto or the use of all or any part of the buildings, grounds or other premises owned or occupied by CAMP ENDOBANAH (the “Camp”, which term includes the Trustees and employees, servants and agents of the camp and their successors and assigns) and for other good and valuable consideration the adequacy and receipt of which is hereby acknowledged, the undersigned organization called:
______
(hereinafter called the “Licensee”, which term includes its members, guests, invitees, employees, agents, successors and assigns) hereby releases, discharges and agrees to save harmless the Camp from any and all actions, causes of action, liabilities, duties, claims, suits, debts, interest, costs, dues, accounts, bonds, covenants, claims and demands whatsoever for damages, loss or injury, howsoever arising, pertaining to or resulting from any matter or thing, including without limitation any mishap, accident, casualty or other incident arising out of the use or condition of the buildings, grounds or premises owned or occupied by the Camp or any part thereof (the “Property”) during the entry onto or use thereof by the Licensee, and the Licensee covenants and agrees that it has obtained and carries adequate liability or casualty insurance in an amount sufficient to cover and compensate the Licensee and the Camp with respect to any risk arising from the Licensee’s entry onto or use of the Property, under policy no:
______issued by ______
(name of insurance company), and the Licensee further agrees not to commence or maintain any action against any person or corporation in which anything hereby released or indemnified could be claimed against the camp by way of contribution or indemnity, and the Licensee hereby acknowledges and agrees that its entry onto or use of the Property is entirely at the Licensee’s own risk and expense.
Name of Licensee:______
Address:______
______
Telephone:______
Date*:______
______
Authorized Signature
______
Title
I have authority to bind the licensee
*Once signed, this form is binding for current and all future use of the camp. It is the responsibility of the renter to inform the CampManagement of any relevant changes that affect the information submitted on this form.
SCHEDULE “B”
CAMPENDOBANAH
RULES AND REGULATIONS
No firearms or fireworks.
Respect the neighbours, be aware of your noise level.
Outdoor fires are to be lit in the camp fire circle only. Check local fire-ban regulations.
Leave the camp cleaner than you found it. Follow camp check-out procedures.
Repair and report all damages that occur while you are at camp.
No food, beverages or cooking apparatus in sleeping cabins.
Pets must have proof of rabies vaccinations.
Observe all standard safety procedures and practices including those pertaining to watercraft and swimming.
No smoking in any camp building.
Do not tamper with smoke detectors, fire extinguishers or life saving equipment.
No Graffiti.
No alcohol or drugs.
Read and follow the guidelines of the campFire Safety Manual.
It is your responsibility to insure your leaders, staff and campers understand and comply with the Rules and Regulations of Camp Endobanah.