Smyrna Parks and Recreation Department
Request For Use Form
Call for availability 615-459-9773

Date of application                 Number of Attending 10 20 30 40 50 75 100 150 200 250 300

Group/Organization or individual   

PHYSICAL ADDRESS

TYPE OF EVENT (DESCRIBE)
 

IS THIS EVENT BEING PUBLICLY ADVERTISED YES NO    IF SO HOW

DATE OF EVENT     TIME OF EVENT TO START 8AM - 2PM 3PM - CLOSE ALL DAY    

PARK REQUESTED LEE VICTORY RECREATION PARK OTHER HILLTOP ROSENWALD PARK SHARP SPRINGS NATURAL AREA ROTARY SOCCER PARK OLD ROCK SCHOOL PARK PIONEER PARK ROCK SPRINGS PARK     SHELTER/OTHER REQUESTED

SECOND CHOICE LEE VICTORY RECREATION PARK HILLTOP ROSENWALD PARK SHARP SPRINGS NATURAL AREA ROTARY SOCCER PARK OLD ROCK SCHOOL PARK PIONEER PARK ROCK SPRINGS PARK     SHELTER REQUESTED

CONTACT NAME     PHONE NUMBER

SECONDARY NUMBER    

WHAT DO YOU NEED FROM THE PARKS DEPARTMENT? (EXTRA TRASH BARRELS, ELECTRICITY, ETC...)

ARE YOU CONTRACTING WITH A SPECIAL EVENT/CATERING/SOFT PLAYGROUND COMPANY? YES NO 

 IF SO WHO

LIST ITEMS BEING BROUGHT BY COMPANY 

LIST ITEMS BEING BROUGHT IN OTHER THAN FOOD BROUGHT IN BY YOU.  (TABLES, TENTS, CHAIRS, GRILLS)

NOTE: CERTIFICATES OF INSURANCE MAY BE REQUIRED, DEPENDING UPON THE ITEMS YOU BRING TO THE PARK, FROM YOU OR YOUR VENDOR.

ALL REQUEST SHOULD BE SUBMITTED 30 DAYS PRIOR TO USE

THIS IS TO CONFIRM THAT THE ABOVE ENTITY MAKING THIS FACILITY REQUEST WILL ASSUME ALL LEGAL AND FINANCIAL LIABILITY FOR GUEST AND PROPERTY DURING THE USE OF CITY OWNED PROPERTY.