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

Please note: All routine requests will be prioritized and handled in an appropriate, timely manner.

Date of application      mm.dd.yyyy           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     mm.dd.yyyy                TIME OF EVENT TO START 8AM - 2PM 3PM - CLOSE ALL DAY    

PARK REQUESTED --Select an Option-- GREGORY MILL LEE VICTORY RECREATION PARK HILLTOP ROSENWALD PARK SHARP SPRINGS NATURAL AREA ROTARY SOCCER PARK OLD ROCK SCHOOL PARK PIONEER PARK ROCK SPRINGS PARK     SHELTER/OTHER REQUESTED  

SECOND CHOICE --Select an Option-- GREGORY MILL 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   xxx.xxx.xxxx

SECONDARY NUMBER      xxx.xxx.xxxx

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.