Name *

First Name

Last Name

Phone *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Start Date

MM

DD

YYYY

End Date

MM

DD

YYYY

Start Time *

Please include, hours, minutes and seconds.

Hour

Minute

Second

AM PM

End Time *

Please include hours, minutes and seconds.

Hour

Minute

Second

AM PM

Day(s) of Week

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Location Specifics

Check all boxes that apply

Ice Rink (November-February) | $196/HR Res. $207/HR Non-Res.

Indoor Turf (March-May) | $115/HR Res. $130/HR Non-Res.

Baseball Field | $50/Game Res. $61/Game Non-Res.

Open Field | $50/Game Res. $61/Game Non-Res.

Is this a Fundraiser? *

Yes

No

Will food or beverage be served? *

Yes

No

General Policies *

General Policies: It is the obligation of the renter to obtain the proper additional permits for any events or rentals. It is the obligation of the renter to procure and maintain at its sole cost and expense, comprehensive general liability insurance in which the City of Rutland is named insured with combined single limit coverage of 1,000,000 per occurrence and 1,000,000 in the aggregate. With special permission, a liability release waiver can be used in place of insurance. All facilities are carry-in, carry-out. The renter is responsible for trash and is obligated to leave the facility as it was found, including but not limited to repairs, damages and cleaning. Securing the building by shutting and locking all windows and doors, as well as turning off all lights once the usage is over. All City facilities are public, and will remain open to the public unless otherwise specified by the Superintendent of Recreation and Parks. However, specific parts of each facility can be rented and closed to the public. There are no public restrooms available at any of these facilities. *

I certify that I have filled out this form completely and understand the insurance expectations.