Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Date Requested *

MM

DD

YYYY

RULES GOVERNING USE OF RECREATIONAL FACILITIES *

As the undersigned, acting on behalf of the designated party, I hereby agree to the following terms: I commit to the complete removal of all waste and refuse from the designated area of reservation. In the event of utilizing PLA-provided grills or personal charcoal grills, I agree to ensure that all hot embers are properly extinguished and subsequently removed from PLA property. Under no circumstances shall any hot or extinguished embers be left within any grill or on PLA premises. Glass containers and alcoholic beverages are strictly prohibited on PLA property at any time, except with explicit authorization from the PLA Board of Trustees. All trash generated during the visit will be promptly removed from the area and not left on PLA premises. Dogs are not permitted at any time on the beaches, playgrounds, or ballfields. Members are responsible for the actions of their children and of their guests. It is the policy of the PLA Board of Trustees to prosecute to the full extent possible, anyone who vandalizes, mars, defaces, damages, degrades, or destroys any property of the PLA. By submission of this form, I acknowledge that I have read and understood the above terms and agree to abide by them in their entirety.

Agree & Submit