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8 ACRE PARK PAVILION RESERVATION APPLICATION
Haines City Leisure Services · 555 Ledwith Avenue · Haines City, FL 33844 · 863-421-3700
DATE _____________________
Facility
Medium Pavilions
(M1-M6)—(25 Capacity)
Large Pavilions
(L1-L3)—(50 Capacity)
RESERVATION DATE ______________________________________
Resident Fee
Non-Resident Fee
Non-Profit Fee
$50.00
$100.00
$50.00
$100.00
$150.00
$100.00
PARK PAVILION (Please Designate Size and Number of Pavilion – See Pavilion Map)
Medium
Large
X-Large
EXPECTED ARRIVAL TIME ___________________
DEPARTURE TIME ___________________
Fall Back (Standard Time) – 8am – 6pm (event must be over and facility cleaned up by 6pm)
Daylight Savings Time – 8am – 8pm (event must be over and facility cleaned up by 8pm)
EVENT DESCRIPTION (Please list if you will be having slide rentals, bounce houses, etc.):
__________________________________________________________________________________________
__________________________________________________________________________________________
(Any event involving slide rentals, bounce houses, etc may require the City to be named as an additional insured under a $1,000,000 liability insurance policy).
Is Electric Required? Yes
No
Estimated Attendance ___________________
NAME ___________________________________________________________________________________
ADDRESS ________________________________________________________________________________
CITY & ZIP CODE ________________________________________________________________________
HOME NUMBER ___________________________
CELL NUMBER ____________________________
I HAVE RECEIVED AND UNDERSTAND THE PARK PAVILION RULES AND PROCEDURES THAT WERE
PROVIDED TO ME BY THE CITY OF HAINES CITY AND AGREE TO ABIDE BY THEM.
SIGNATURE ____________________________________________
DATE_________________________
Office Use Only:
Rental Fee:
Staff Initials: ___________________
Cash: ______________________
Driver’s License: ___________
Date Received: _________________
Check #: ____________________
Proof of Residency: _________
Rental Fee Amount: _____________
Credit #: ____________________
Tax Exemption #: __________
Debit #: ____________________
Receipt #: ________________
Pavilion Rules and Regulations
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APPLICATIONS AND PAYMENTS MUST BE MADE IN FULL 7 DAYS PRIOR TO THE PROGRAM/EVENT TO RESERVE A
DATE. RESERVATIONS CANNOT BE MADE OVER THE PHONE. PLEASE MAKE CHECKS PAYABLE TO THE HAINES
CITY LEISURE SERVICES DEPARTMENT. All applications for reservations must be accompanied by the appropriate rental fee
and are subject to the approval of the Leisure Services Director or his/her designated representative. The Recreation Supervisor will
act upon all requests within two working days. Applicants are encouraged to make reservations as early as possible.
Reservation of the extra large pavilion requires a clean-up/damage deposit of $200.00 in addition to the user fee. The deposit is to be
paid prior to the day of the event and will be returned the Monday following the event, as long as the facility has been cleaned, rules
have been followed and there is no damage to the facility.
The City may cancel any rental if use of the property in any way conflicts with Federal, State, or Local Laws, or if the occupancy, in
the opinion of the Leisure Services Director, operates to discredit the City of Haines City.
The applicant is solely responsible and answerable for damages for any accidents or injuries to persons or property resulting from
his/her use of the facility.
The City of Haines City assumes no responsibility for personal property, such as decorations, flowers, shrubs, etc. used or left on the
premises by persons reserving any recreation facility. Such properties will be removed no later than the expiration time of the
reservation unless special arrangements are made through the Leisure Services Department at the time of application for reservation,
and the City of Haines City, its officers and employees will not be held liable for any such properties remaining on the premises after
the appointed time.
The permitted use of the City of Haines City recreation facilities will be without discrimination because of race, religion, color, creed,
or national origin. All rules and regulations governing use of the facilities as filed apply to the Leisure Services Department.
All participants must abide by the written regulations of the Leisure Services Department and the City of Haines City. ALL park
rules must be maintained. Anyone not complying with any of these regulations will not be granted use of the facility in the future. If
unsure of all of the rules it is the user’s responsibility to make themselves aware all rules.
Some applicants may need to supply a "Certificate of Insurance" equal to the amount carried by the City of Haines City, depending
on the nature of the activity.
THE CITY OF HAINES CITY HAS A NOISE ORDINANCE. You must keep any music to a minimal volume at all times. If
anyone complains about the noise, the Leisure Services Director, Department Designee and/or police department will shut down the
party immediately. Lake Eva Park is open from dawn to dusk. The time for reservations are as follows:
Fall Back (Standard Time) – 8am – 6pm (event must be over and facility cleaned up by 6pm)
Daylight Savings Time – 8am – 8pm (event must be over and facility cleaned up by 8pm)
PARK PAVILION RULES
1.
Any deviation from activities listed and approved on the application will result in an automatic cancellation of event and forfeiture of
total reservation amount.
2.
All renters are responsible for cleanup of the facility and its grounds. All clean up must be completed immediately following the
event and is within the time listed in the event application.
3.
Decorations and all activities must be approved by the Recreation Supervisor or his /her designated representative before being placed.
Decorations may NOT be attached to the pavilion with any materials that will result in damage to the pavilion (no nails, thumbtacks or
other materials that will leave behind holes). Violating these rules will result in the loss of your reservation and fees.
4.
No groups will conduct any activity causing extra labor for the custodian unless a previous agreement made by the Leisure Services
Director has been met.
5.
Under no circumstances will anyone be permitted to remove benches, tables, grills or any other equipment from underneath park
pavilions.
6.
Gambling in any form will not be allowed.
7.
Under no circumstances will anyone be permitted to have alcohol or illegal drugs in the park or on its premises.
8.
At no time will vehicles be allowed in the park. You must carry all equipment or use a handcart to transport all supplies to the
designated area.
9.
All litter resulting from the use of the pavilion must be picked up and deposited in the outside refuse containers, before leaving the
area.
10.
Anyone not complying with any of these rules will not be granted use of the facility in the future & will forfeit any fees paid.
11.
Bounce house / Inflatables must be powered by a generator and NOT off the power from the pavilions.
12.
Bounce houses /inflatable rentals will require one million dollars worth of liability insurance listing the city as the additional insured.
REFUNDS
1.
If cancellation occurs twenty (20) calendar days before a program/event, a 100% refund will be given for rental fees and deposits that
have been paid.
2.
If cancellation occurs nineteen (19) calendar days or less, before a program/event, a 50% refund will be given for rental fees and
deposits that have been paid.