CITY OF HOBOKENDEPARTMENT OF HUMAN SERVICES

DIRECTOR'S OFFICE

DawnZinlmerMayor

Leo PellegriniDirector

ACTIVITYfFIELD/CAFE PERMIT REQUEST

Permission is here-by granted to use:

Sinatra ParkMaxwell Place ParkRoller Rink (124 Grand St.)Sinatra Park CafeSinatra Park1600 Park Avenue

1500 Park AvenueMulti Service Center (Gymnasium)Skateboard ParkPier A. ParkLittle League Field

on at--------------------------- ---------------------------------(Date) (Time)

for----------------~---------------------------------------------(listevent)Name of applicant: _

Address of applicant: _

Telephone number of applicant: Day: -:Evening: _

Cell phone number: Email address: _

Note: Permit must be in the possession of individual/organization at all times whenusing any of the above facilities.

***RULES AND REGULATIONS GOVERNING THIS FACILITY***

1. Application must be received no later than thirty (30) day prior to the event.2. All organized ball games shall be limited to 2 Yz hours.3. The permitee shall be responsible and clean the area after the event or a service charge will be

accessed.4. The permitee shall be bound by all park rules, all applicable ordinances and any and all permit

restrictions.5. All persons to whom a permit is issued shall be liable for any loss, damage or injury to any person

or persons whatsoever by reason of negligence of the permittee. The City of Hoboken shall not beliable in such instance.

(continued)

94 Washington Street, Hoboken, New Jersey 07030 Telephone #201-420-2012 Fax #201-239-6631

CITY OF HOBOKENDEPARTMENT OF HUMAN SERVICES

DIRECTOR'S OFFICE

Dawn ZimmerMayor

Leo PellegriniDirector

6. The Director of the Department of Health and Human Services or the Recreation Superintendenthave the authority to revoke a permit upon a finding of any violation hereunder or upon goodcause.

7. No food or beverages will be allowed on athletic fields.8. Applicants are to adhere to all other Park Regulations as per Section 58-19 through 58-21.758-

21.2BB - NO ALCOHOLIC CONSUMPTION OR CARRYING OF UNSEALEDALCHOLIC BEVERAGE CONTAINERS SHALL BE PERMITTED IN ANY PARK.

Permit fee - There is a $125.00 (per hour) application fee for any individual requesting use of theabove referenced facilities. (Please make your check or money order payable to: "The City ofHoboken").

1 ote: Any non-profit organization or school shall have their fee waived but must supply aninsurance rider indemnifying the City of Hoboken or sign a waiver which would hold the Cityharmless.

If you have any questions regarding this permit or would like to cancel your event, please callthe Division of Recreation at (201) 420-2094 or the Department of Health and Human Services at(201) 420-2012.

Applicant's Signature Dated:

Superintendent of Recreation or designee Dated:

Director of Human Services Dated:

Permit fee:'------------------------Check/money order # _

94 Washington Street, Hoboken. New Jersey 07030 Te1ephone #201-420-20 12 Fax #201-239-6631