Park Reservation Form Please call or email the YMCA prior to filling out this form to check availability of your date/time. They can be contacted by phone at (720) 274-5759 or email at firstname.lastname@example.org Applicant Full Name Applicant Address City State ---ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYZip Daytime Phone Number Alt/Cell Email Contact Person Onsite Number of People Attending Purpose of Rental Date Requested Event Time AMPM to AMPM (Rentals are available Monday-Sunday during daylight hours up to 4 hours.) Are you a Wheatlands Resident? YesNo Pavillion/Area Requested (6171 S Wheatlands Parkway) Main Park Pavilion (Resident: $25.00 Non-Resident: $50.00)Small Park Pavilion (Resident: $25.00 Non-Resident: $50.00) Damage Deposit: $75.00 (Credit Card will be held on file for damage deposit. Damage deposit will only be charged if damage occurs) *Please note use of sports fields for organized play must be arranged separately by calling 720.274.5759 Once you have submitted this form the YMCA will call you to confirm they have received your paperwork and will take your credit card information over the phone. The credit card you provide will be kept on file for the damage deposit and will be used to pay your rental fee. APPLICANT HAS RECEIVED, READ, AND AGREES TO ABIDE BY THE WHEATLANDS METROPOLITAN DISTRICT PARK RESERVATION AND PERMIT POLICY Park Reservation and Permit PolicyDownload (Type Initial) INDEMNIFICATION/WAIVER OF LIABILITY: Applicant, its successors and assigns, assumes all liability and risk and will defend, indemnify and hold harmless the Wheatlands Metropolitan District (the “District”), the District’s directors, staff, employees, consultants, licensees, invitees, agents, successors, and assigns from any and all injuries, loss, claims, liability, damages, and costs, including, without limiting the generality of the foregoing, court costs and attorneys’ fees, caused by, resulting from, or in any way arising out of the use of the premises by the applicant, its guests, licensees, invitees, agents, contractors, subcontractors, employees, successors, and/or assigns. INSURANCE REQUIREMENTS FOR BUSINESS ENTITIES AND VENDORS: Applicant shall, at its own expense, obtain and maintain during the term of this agreement, General Liability Insurance with a limit of $1,000,000 per occurrence and a $2,000,000 general aggregate limit. Applicant will provide a certificate of insurance including the YMCA and District as Additional Insureds. Signature implies legal responsibility for compliance with all the conditions as outlined by the District.