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Facility Permit Application

2. 

3. City of Palm Beach Gardens Facility Permit Application

5. Facility Use Application Acknowledgements

7. Facility Use Policies & Procedures
   Click here to read the City's Facility Use Policies & Procedures.

9. I have read, understand, and agree to comply to the City's Facility Use Policies and Procedures. I understand that, if I am granted a permit, I am responsible for all participants of the permitted activity understanding the Facility Use Policies & Procedures as well. Further, I understand that I am responsible for the actions of the participants of the activity.*

   1. I agree

11. COVID-19 Waiver
    Click here to read the City's COVID-19 Waiver

13. I understand that the City's COVID-19 waiver will accompany the permit once any issued permit is paid for. I attest that it is my duty to ensure all participants (players, referees, spectators, coaches, etc.) of the permitted activity have signed the waiver prior to arriving at any City of Palm Beach Gardens facility. I understand that it is my duty to make copies of the form, as needed. I understand that any and all participant waivers must be made available to the City upon request. If at any point the permit holder is found not in compliance with this requirement, all permits are null and void.*

    1. I agree

15. For programs with youth participants I agree to require the Parent(s) and/or Guardian(s) of all program participants to execute the COVID-19 Waiver and Assumption of Release, attached hereto. Execution of the COVID-19 Waiver and Assumption of Release by the Parent(s) and/or Guardian(s) of program participants constitutes a material inducement for the City to enter into this City Facility Use Permit. Accordingly, failure to have the the COVID-19 Waiver and Assumption of Release properly and timely executed shall constitute a material breach of this Agreement. *

    1. I agree

19. Contact Information

21. Organization: *

23. First Name*

24. Last Name*

26. Address*

28. City*

29. State*

30. Zip*

32. Email Address*

33. Phone Number*

37. Activity Information

39. Briefly describe the nature of the activity.*

41. Start and End Date/Time*
    Start and End Date/Time Start Date

    Start and End Date/Time Start Time

    —

    Start and End Date/Time End Date

    Start and End Date/Time End Time

42. Age Group*

    1. Youth
    2. Adult
43. Number of Participants*

45. Which type of permit are you requesting?*

    1. Daily

    1. Block

    1. Event/Tournament/Camp

    Please reference the Facility Use Policies & Procedures above to decipher the best fit.

47. If you are requesting a block permit, which days of the week do you prefer?

    1. Sunday
    2. Monday
    3. Tuesday

    1. Wednesday
    2. Thursday

    1. Friday
    2. Saturday

49. Please select which parks/facilities this event wishes to utilize.*

    1. Burns Road Community Center
    2. Gardens North County District Park
    3. Gardens Park Baseball Complex

    1. Lake Catherine Sportsplex
    2. Lilac Park
    3. Mirasol Park

    1. PBG Tennis & Pickleball Center
    2. PGA National Park

    1. Plant Drive Park
    2. Russo Athletic Complex
51. Please specify the type of facility (meeting space, multipurpose fields, baseball fields, tennis courts, etc.) you are requesting.*

53. Please provide any other important information or comments.

Leave This Blank:


55. 1. Receive an email copy of this form.
56. Email address

    This field is not part of the form submission.

57. Submit Submit and Print

* indicates a required field