I, the undersigned Permit Holder, have read and understand the Poland Township Oak Grove Pavilion Rental Policies and Rules on the use of the Poland Township’s Oak Grove Pavilion and agree to comply with the Policies and Rules. I will attend the Event and I understand and agree that I am responsible for the group’s conduct and respect for the facility. I understand that I am responsible for cleaning up the Pavilion and surrounding area before the end of the rental time. I further understand that any property damage to the Pavilion and the surrounding area and any costs for property damage will be charged against me, the Permit Holder.
For and in consideration of the permission to use the Pavilion owned by Poland Township, I, the undersigned, agree for myself, my heirs, executors, administrators, personal representatives, event participants and assigns, to release, acquit, discharge, covenant not to sue, indemnify and hold harmless, Poland Township, the Poland Township Board of Trustees, its employees, officers, servants, and agents of and from any and all actions, causes of actions, claims, demands, damages, loss of services, expenses and compensation, of whatever kind or nature, present or future, which I, myself, my heirs, executors, administrators, personal representatives, event participants and assigns, have or may have on account of, or in any way arising out of, any and all personal illness, injury or property damage which may result from or in any way connected with Poland Township allowing me to use the Pavilion owned by Poland Township. I further acknowledge that I assume all risks of harm, injury, and property damage associated therewith.
Senior Watch Program application form PDF Download. In addition, you can complete the online version of the form below.