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Park Pavilion Rental/Reservation Form

  1. Responsibilities of the Organization or Responsible Party*

    1)Remove all trash from site. 2)Remove all extra equipment - tents etc 3)Maintain a safe play environment 4)Online Payment is to be made at the time of Reservation 5)Cancellations must be made 72 hours prior to the event otherwise there are no refunds. 6)Please remember your social distancing.

  2. Park Rules and Regulations*

    PARK RULES 1. Park hours – Individual park hours shall be determined by the County Board of Supervisors from time to time and shall be posted on park premises. a. All trails will open at sunrise and close at dusk. Lights if available must be turned off at 11:30 p.m. 2. Fires may be kindled only in grills and fireplaces provided in the park or in private grills. 3. Alcoholic beverages and illegal narcotics are prohibited on park property. 4. Motorized vehicles are prohibited in the park except on roadways and parking areas. 5. All pets shall be kept on a leash while in the park. a. All pets shall be restrained while in the park. Pet owners are required to clean up their pets waste. 6. It shall be unlawful for any person to kill birds or animals within the park. 7. The amplification of music, speeches or any other sound within the park shall be subject to the applicable provisions of the County, and also subject to conditions imposed by any permit(s), which may be required. 8. No selling or vending of food, drink, or other objects shall be allowed in the park except by special permission from the Director of Recreation or the County Administrator. 10. No behavior deemed unsafe to individual or other visitors is permitted on the premises. 11. No utilization of park property for personal financial gains, unless approved by the Director of Recreation or County Administrator. 12. Park facilities may be reserved by filing an application and processing a permit with the Department of Recreation, P.O.Box 369, Rustburg, VA 24588 or online at . Permits must be carried and produced upon request of an authorized County Personnel . Fees may apply. 13. The Director of Recreation or the County Administrator shall have the authority to revoke a permit upon finding a violation of any rule, ordinance, and state law, condition of the permit or upon good cause shown. 14. No boats, swimming or wading will be allowed in the pond. 15. Fishing will be allowed. All fish caught must be released back into the pond. 16. Children under 16 years of age must be accompanied by an adult to fish in the pond. 17. No equestrian activities are permitted on the park property, unless authorized by a special permit issued by the Director of Recreation or County Administrator.

  3. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

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  5. This field is not part of the form submission.