I hereby request the use of the following facility (specify park, shelter house, gazebo, street(s), or other Village property):
Applicant must furnish a copy of his or her insurance policy, demonstrating that general liability insurance coverage exists for the Applicant’s intended use of Village property, in a minimum amount of one million dollars ($1,000,000.00). A copy of the applicant’s insurance policy must include all policy exclusions. Individuals, not acting on behalf of the organizations referenced below, are exempt from the proof of insurance requirement.
Public entities (including but not being limited to Bloom-Carroll Local School District, Greenfield Township Fire Department) are exempt from the proof of insurance requirement. All other entities (including but not being limited to summer youth programs, athletic organizations, quasi-public entities, Carroll Community Festival, etc) are not exempt from the proof of insurance requirement.
Applicant hereby agrees to hold the Village of Carroll, its officers, agents, and employees harmless from any and all liability or responsibility for any injury or accident which might occur on park or street premises. The Village of Carroll reserves the right to cancel this contract or to make a decision on any situation not covered herein.
Applicant hereby acknowledges that he or she has read and agrees to comply with the terms and conditions of this contract.