Recreation Center Rental Form Application Date Organization Contact Person PhoneNumber Work/Cell Phone Email Address Street Address City, State, Zip Date of Activity Start Time End Time Type of Event Number of People Room Requested Purpose Payment Acknowledgment I acknowledge that payment must be sent or dropped off within 5 days of reservation. I understand and do hereby agree that: 1. No alcoholic beverages are permitted. 2. Individuals involved in the activity are limited to the use of that area. 3. I assume the responsibility for any property damage. 4. The User Agency and the individuals participating in the program sponsored by the User Agency at Slippery Rock Area Parks & Rec. hereby agree to indemnify and hold harmless from any liability whatsoever arising from the use of the Slippery Rock Park, the Slippery Rock Park and Recreation Board, its individual members, its Employees, the Borough of Slippery Rock, the Township of Slippery Rock, and Slippery Rock School District. 5. My reservation will not be accepted without payment. *ALL FEES ARE NON-REFUNDABLE 6. In order to charge admission to this function, I must provide proof of a one million dollar insurance policy. Charging admission to this function is not permitted unless this proof of insurance is provided. 7. No activity is permitted in the Park after sunset.