Special Use Applications and Permits
Please review this information page to determine which application/s you need to complete and submit. You do not have permission for your activity until a Permit is issued to you from the Monroe County Parks Department.
Special Use Applications are to be filled out if your PROPOSED activity is ANY of the following:
1) it is open-to-the-public; and/or
2) it falls into any of the four categories described below:
A. Event (pages 2-8): All open-to-the-public Benefits or Fundraisers; All Races, Runs, Walks, or Rides, etc.; all Festivals, Concerts, or Performances; all Commercial Film/Photo Shoots; all Fishing Derbies, Boating Events, Summer Camps, and all Camping events that are over 50 people.
B. Field (Page 9): All single-day or seasonal athletic field use, leagues, tournaments, and athletic events; all fee-based Clinics, Classes, Tours, or Recreation Club activities or programs that are not considered Events.
C. Recreation (Page 10): All free and open-to-the-public Clinics, Hikes, Classes, Tours, or Recreation Club activities or programs that are less than 25 people (over 25 people will need to complete a Field or Event Application); all Non-commercial or Student Film/Photo Shoots.
D. Private Rental (Page 11): All Large (i.e. over-capacity of lodge or shelter) Weddings/Ceremonies/Receptions/Photos, Rehearsal Dinners, Corporate Functions, Company Picnics, Church Picnics, Graduation Parties, Pig Roasts, Fraternity or Sorority Parties, etc.; all requests for a private event that is not associated with a lodge or a shelter (Rental of additional facilities may be required in order to accommodate your parking, bathroom, or other needs.)
[ ] Timeline: If you are planning to obtain a Special Use Permit for a Monroe County Park in 2014, please fill out the pertinent
page/s in this document and submit it/them to the Monroe County Parks Department according to the schedule below:
A. Event- Part 1 at least 45 days prior to your proposed event. Part 2 at least 21 days prior to your proposed event.
B. Field- starting January 31, 2014 at 8:30am, and at least 14 days ahead of the date of the activity/ies or program/s.
C. Recreation- at least 45 days prior to your proposed activity/ies or program/s.
D. Private Rental- upon reservation of facility, and at least 14 days ahead of the date of the reservation.
[ ] Certificate of Insurance: If your event qualifies as a “Special Use Event,” as noted above (Except D: Private Rentals) please
obtain and submit a copy of your organization’s “Certificate of Insurance” (COI) that fulfills the following requirements:
· “Monroe County” must be added as an “additional insured” in the following format. No other formats will be accepted.
o "Monroe County, 39 West Main Street, Rochester, NY, 14614"
· Must be accompanied by an “endorsement” of the COI
· Monroe County must also show on the endorsement page as "Monroe County, 39 West Main Street, Rochester, NY, 14614"
· Policy must be effective for the date/s of the event/s, activity/ies, or program/s in the Monroe County Parks
· Must meet these Minimum Liability Limits
o $1 million/occurrence AND $3 million aggregate.
§ If aggregate is less than $3 million, then the COI must have
· Excess/Umbrella coverage in the amount to provide $3 million total; and
· Excess/umbrella coverage must list Monroe County as additional insured, and provide an endorsement that shows Monroe County as additional insured.
Please submit your completed application/s and any pertinent accompanying documents via e-mail to firstname.lastname@example.org, via fax 585-753-7284, via US Mail, or in person at 171 Reservoir Ave, Rochester, NY 14620. You can also visit www.monroecounty.gov/parks, the Monroe County Parks Department, or contact Ryan Loysen at 585-753-7281 in order to obtain blank copies of this “Special Use Application” and/or obtain other pertinent information about obtaining permits in the Monroe County Parks. Most items in blue are webpage or email links in the online version of this document. *If your organization has several events planned for 2014 of a similar nature, you only need to fill out this application once, as long as you include detailed information about each separate activity date.