Park / Playfield Agreement
Group Name: ____________________________________________________________
Contact Name: ___________________________________________________________
Address: ________________________________________________________________
City: ____________________ Postal Code: _______________ Telephone: ___________
Park / Playfield Requested: _________________________________________________
Owned by:
Town of Lake Cowichan _____________
C.V.R.D. _______________
Dates and times Requested: _________________________________________________
Insurance requirements met? _________
•
Damage Deposit of $100 received? _______
Proof of third party liability insurance in the amount, of a minimum, of $2,000,000 (two million dollars) must
be provided prior to the start of the event. For Lake Cowichan Centennial Park, Lake Cowichan Little
League Park, Lake Cowichan’s old Tennis Courts and the Claude Ruggerri Memorial Skateboard Park, this
insurance must name both the Town of Lake Cowichan and the Cowichan Valley Regional District as
additional insured. For Youbou Little League Recreation Park, Mesachie Lake Skydome, and Honeymoon
Bay Little League Park, this insurance must name the Cowichan Valley Regional District as additional
insured.
Special Occasion license? __________________________________________________
q
Clearance from Lake Cowichan RCMP?
q
Approval from the Town and/or the CVRD?
q
Provision of toilet facilities and toiletries?
q
Clearance from Public Works Superintendent
(for parks/playfields owned by the Town)?
q
Clearance from the CVRD Parks Department
(for parks/playfields owned by the CVRD)?
q
Clean up of area after event?
Damage Deposit returned? Date:______________
q
Conditions of Use
1.
Groups using parks/playfields are responsible to pick up litter and debris during and after the event. If your
group does not clean the field to a standard acceptable to staff working for the Town of Lake Cowichan
(Town) and/or the Cowichan Valley Regional District (CVRD), your group will be charged the cost incurred
by the Town or the CVRD to clean the park/playfield.
2.
Groups (including friends and spectators) using parks/playfields are expected to act in a considerate and
sportsmanlike manner. Abusive language or inconsiderate behaviour, which is found objectionable by local
residents, will result in the immediate cancellation of your park/playfield use.
3.
If your group holds a tournament/event on a playfield where no washrooms are located, the group must, at its
own expense, have a portable washroom unit brought to the site for tournament/event duration.
4.
Liquor is not to be consumed in any park/playfield except where a beer garden license has been approved by
the Town or the CVRD and whereby clearance has been received from the Lake Cowichan RCMP.
5.
If your group holds a beer garden event, at least two (2) portable washroom units must be brought on the site
for the event duration.
6.
It is the responsibility of your group’s tournament/event coaches and game officials to ensure the playfields
are in good playing condition (free from glass, obstructions, etc.). If a hazard exists on a Town of Lake
Cowichan owned playfield please notify Public Works at 749-6244 (after hours 715-9730). If a hazard exists
on a CVRD owned playfield please notify the Parks Department at 746-2500.
7.
The operation of a concession on a park/playfield must receive the prior approval of the Town and/or the
CVRD.
Waiver & Indemnity Clause
I hereby agree that the _____________________________________________ (hereafter called
the Group) will use the park/playfield at its own risk and that the Town of Lake Cowichan
(hereafter called the Town) and/or the Cowichan Valley Regional District (hereafter called the
CVRD) has made no warranties or representations respecting the suitability or condition of the
park/playfield. I further agree that the Group will indemnify and save harmless the Town and/or
the CVRD, its officers and employees from and against any and all claims including damages,
liabilities, expenses and costs, including legal and other fees incurred in respect of any such
claim(s), action(s) and proceeding(s) brought thereon arising directly or indirectly from, or in
connection with this Agreement and use of the park/playfield. I hereby agree to ensure that the
rules governing the use of the parks/playfields are carefully observed by the Group.
Dated this _____________day of ________________, 200_.
Telephone:_________________
________________________________
Signature on behalf of Group
__________________________
Print name
________________________________________________
Manager or Deputy Manager of Cowichan Lake Recreation
Note: The Town and/or the CVRD reserve the right to cancel or alter field use should
conditions arise which may make schedule changes necessary.