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2. Applicant Name
3. Today's Date
   Today's Date
5. Name of Organization (If Applicable)
7. Location Requested

   1. Dick Strong Memorial Field/Park
   2. Field One
   3. Field Two
   4. Field Three
   5. Graham Park

   1. Greenbrier Lake
   2. Louse Martin Park
   3. Shadowbrook Park
   4. Soccer Pavilion
   5. Other
9. Do you need this field for the entire day?

   1. Yes
   2. No
10. Specify Other Location
12. Fees
14. Non-league Practice
    $25 per hour with no lights, $35 per hour with lights
15. Press Box with Field
    $30 per hour with no lights, $40 per hour with lights
16. Baseball Pavillion
    $10 per hour
18. Field Per Day
    $100
19. Press Box
    $10 per hour
20. Dick Strong Memorial Field/Park
    $30 per hour with no lights, $40 per hour with lights
21. Soccer Pavilion

    $10 per hour

23. Name of Event
25. Requested Date of Event
    Requested Date of Event Start Date

    Requested Date of Event Start Time

    —

    Requested Date of Event End Date

    Requested Date of Event End Time
    This should include setup and clean up time.
26. Actual Event Time
    Actual Event Time
28. Primary Contact Name
29. Email Address
31. Address
33. City
34. State
35. Zip Code
37. Day Phone
38. Cell Phone
40. Event Description
42. Estimated Number of People Attending
43. Number of Staff/Volunteers
45. Specify the area within the park that you want the event to take place at.
47. Site Plan*
49. Will fees, charity, gratuity, or offers be solicited or accepted?
    If yes, please describe.
51. Will any tents, structures, stages, and/or amusement attractions or rides be erected?
    If yes, describe and name the company from which the items are being secured. Please note that some amusement attractions require additional insurance coverage, and water inflatables are not permitted.
53. Will signs or banners be posted?
    Signage may be posted only on the day of the event. If being used, please describe signs or banners.
55. Will any merchandise be sold or given away?
    Please note that you are responsible for all local, state, and federal guidelines. Describe any merchandise being sold or gifted.
57. Will live music and/or sound amplification be used?
    Compliance with the City of Greenbrier’s Sound Ordinance is required. Please describe any live music or sound amplification.
59. Please describe any other relevant information or requests.
61. Electronic Signature*

    I have read the Guidelines for Special Use, and agree to abide by these guidelines as well as all ordinances and regulations of the City of Greenbrier and by all the conditions placed on the event by the Greenbrier Parks and Recreation Department. I do swear and affirm that all of the information given is true and complete. I understand submittal of this application does not guarantee approval.

    1. I agree
63. Name*
64. Date*
    Date
Leave This Blank:


66. 1. Receive an email copy of this form.
67. Email address

    This field is not part of the form submission.

68. Submit

* indicates a required field