2008 Stroud Township Field Reservation Application
                                                                               Stroud Township, 1211 North Fifth St., Stroudsburg, PA 18360
                                                                                               570-421-3362   stroud17@ptd.net

Please check off which field you are interested in. Fees are the same for residents and non-residents
Big Pines Park
    __ Softball field – 1 event $15., season $125. (up to 21 scheduled events),$175. over 21 events $____
    __ Soccer field – 1 event $15., season $125. (up to 21 scheduled events),$175. over 21 events $____

 Brodhead Creek Park
    __ SMA Field – no fee

 Total Reservation Fee $ _____     Check # ______     Cash ____  Money Order _______

Date(s) and time(s) requested, including start and end times: _____________________________________________________________

______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________

      Please note that users must: NOT MOVE THE BASES. Users must clean up the area after use, rake the infield after use, remove any trash that does not fit in trashcans with lids closed tightly, park in designated spots only, refrain from tobacco and alcohol use on park property, exit the park as soon as reserved time is over so that parking is available for the next group, and if applicable, line fields and provide goals after consultation with Ron Tinney - Park Maintenance (570-421-3362).  Please read all Field Usage Rules

 Individual Reservation:
Person requesting Reservation: _____________________________________________

 Address: ___________________________________________________________________________

 Daytime Telephone #s: ____________________________   E-mail: ____________________________

 Description of Usage: _________________________________________________________________

 Number of Children age 4 - 12  _____     Number of Teens age 13-19 ____    Number of Adults _______                                                                                                                                                                                                                                                                              

 Team Reservation: I, ____________________________, am authorized to represent the

                                                  
Organization: ____________________________________________                       signature   _________________
                                                                                                                                                                                                                          

Organization Address: ________________________________________________________________

 Contact Person’s Daytime Telephone #s: ________________________  E-mail: ___________________

 Description of Usage: _________________________________________________________________

 Number of Children age 4 - 12  _____     Number of Teens age 13-19 ____    Number of Adults _______

 All applicants, please read and sign:

I, ______________________________and/or the organization I represent, accept the legal and financial responsibilities involved in the use of Township facilities. I assume all risks and hazards incidental to the activity related to this use, to the extent permitted by law. I hereby release, absolve, and hold harmless Stroud Township, the Stroud Township Park and Recreation Board, and their agents and employees from any and all liability, reason of damage, or injury to any person or property arising from our use of Township facilities.  I have received and agree to abide by, the rules and regulations of Stroud Township Ordinance No. 2-2001 and notify all participants at the event of these rules and regulations.

                                                                                                     _________________________________
                                                                                                                                 signature

 02/07/08