Use of Ipswich Town Greens Application

2. Please review:
   Rules and Orders Regulating the Use of the Ipswich Town Greens (PDF)

4. Section I

6. Requesting Organization

7. Date
   Date

9. Name of Applicant

11. Phone Number

12. Email Address

14. Physical Address

15. Mailing Address

17. City

18. State

19. Zip

21. Section II

23. Requested Facility / Specific Area(s)

    1. Center Green

    1. North Green

    1. South Green

    1. Other

25. Other Location Requesting

27. Date(s) Desired for Activity
    Date(s) Desired for Activity

28. Time of Activity
    Time of Activity Start Time

    —

    Time of Activity End Time

30. What time do you need to access the green?
    What time do you need to access the green?

31. What time will you exit the green?
    What time will you exit the green?

33. Nature & Proposed Use

35. Area of the Green

36. Access to paved area?

    1. Yes

    1. No

38. Number of Adults Attending

39. Number of Children Attending

40. Number of Teens Attending

42. Will refreshments be served?

    1. Yes

    1. No

43. Board of Health approval needed?

    1. Yes

    1. No

45. Will streets and/or sidewalks be blocked or closed?

    1. Yes

    1. No

46. BOS approval?

    1. Yes

    1. No

48. If Merchandise Is to Be Sold, Please Describe (Percentage Profit of Items to Be Negotiated)

50. Please Outline or Attach Your Clean-up Plan

52. Attach Plan

54. By signing this application, the person whose signature appears below signifies that he/she is personally, financially responsible for their group, will see that the greens are not misused, that groups have proper adult supervision, that properties are used in conformity with policies established by the Town of Ipswich, and that any damages and/or loss whatsoever as a result of the group’s use of properties will be compensated in full by the responsible person, upon demand.<br><br> It is hereby understood by the responsible person signing this application that any town activities have absolute priority for use of any portion of the green, even if an outside group (e.g., the applicant) has requested the use of a portion of the green for several weeks. Any town activity whatsoever that may be subsequently scheduled shall have absolute priority for use of the greens.<br><br> The Town of Ipswich disclaims liability for loss or damage to personal property or personal injury, and the applicant individually and on behalf of each member of his/her group agrees to release and hold harmless the Town of Ipswich officials and employees and not to sue any of the same for any such liability or loss.<br><br> I hereby personally accept on behalf of the sponsoring organization all financial responsibility for any and all damages to equipment and/or greens and all resulting cost of any nature whatsoever.

    By signing this application, the person whose signature appears below signifies that he/she is personally, financially responsible for their group, will see that the greens are not misused, that groups have proper adult supervision, that properties are used in conformity with policies established by the Town of Ipswich, and that any damages and/or loss whatsoever as a result of the group’s use of properties will be compensated in full by the responsible person, upon demand.
    
    It is hereby understood by the responsible person signing this application that any town activities have absolute priority for use of any portion of the green, even if an outside group (e.g., the applicant) has requested the use of a portion of the green for several weeks. Any town activity whatsoever that may be subsequently scheduled shall have absolute priority for use of the greens.
    
    The Town of Ipswich disclaims liability for loss or damage to personal property or personal injury, and the applicant individually and on behalf of each member of his/her group agrees to release and hold harmless the Town of Ipswich officials and employees and not to sue any of the same for any such liability or loss.
    
    I hereby personally accept on behalf of the sponsoring organization all financial responsibility for any and all damages to equipment and/or greens and all resulting cost of any nature whatsoever.

56. Responsible Person Signature (Applicant)

58. Approved By (Town Official Signature)

59. Date
    Date

61. Equipment Use Approved

    Included Equipment Details

    1. N/A
    2. Yes

    1. No
62. Equipment Details

64. Merchandise Sale Approved

    1. N/A
    2. Yes

    1. No

65. Refreshments Approved

    1. N/A
    2. Yes

    1. No

67. Police Detail Required / Scheduled

    1. N/A
    2. Yes

    1. No

68. Sidewalk / Street Blocking Approved

    1. N/A
    2. Yes

    1. No

70. Other Comments / Conditions of Use

72. Town Manager Approval

73. Date
    Date

75. Comments

Leave This Blank:


77. 1. Receive an email copy of this form.
78. Email address

    This field is not part of the form submission.

79. Submit

* indicates a required field