BC 2010 02 15 Regular - Laserfiche WebLink

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February 15, 2010 (Regular Meeting) Page 1817 Address City/State/Zip Home Phone # Cell Phone Email Address: Tournament Name: Tournament Type (Inv., reg., state, national) Tournament Date: On Site Director: Phone: Time of First Game/Last Game: Friday: / Saturday: / Sunday: /_ Game Schedule Attached: # of Teams in Tournament: # of Fields Requested: Gate Fee Being Charged: Base Distances: 60 (please specify) Field Supplies Requested: Yes Age Groups:_ Circle all that apply: F1 F2 Yes 65 Pitching Distances: Yes F3 F4 NO _35 _40 -Other No I hereby certify that I am the authorized and responsible representative for the tournament organization, that the above statements are true to the best of my knowledge, and that I have received and read a copy of the rules and regulations governing the use of the facilities; and that our group will comply with the regulations, policies, and fee schedule governing the use of the facility. The undersigned applicant hereby agrees to indemnify and save harmless the Cabarrus County Parks Department from and against any and all loss, costs, damages, expense and liability causes by any accident or other occurrence causing bodily injury or property damage or damage for libel or slander to any person or property arising from or out of the use or occupancy of the premises by the undersigned applicant, its agents, employees, or invitees. The person to whom this facility agreement is issued to will be the contact person and/or site director for this tournament and must be on site during the duration of this event. The post tournament checklist must be completed by tournament director and park ranger and/or park manager prior to leaving at the end of each day. Failure to leave facility clean and free of trash from grounds will result in all or a portion of the security deposit being forfeited. Today' s Date Signed Tournament Director Today' s Date Park Program Manager For office use only: Permit # Receipt # (Check One) Check Cash Credit Card Amount Paid Date Paid Notes: (To be completed by Tournament Director and Park Ranger/Manager after completion of tournament) Bases F1 F2 F3 F4 Needs Replaced Check if bases are on fields and in working condition. If bases are missing, note which bases are missing and which fields. Pitching Plates Fl F2 F3 F4 Needs Replaced Check if pitching plates on each field and in working condition. If any are missing, note which ones are missing and which fields. Signed No Home Plates F1 F2 F3 F4 Needs Replaced