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2. Name of Organization
4. First Name
5. Last Name
7. Title
9. Address of Applicant
11. City
12. State
13. Zip Code
15. Phone
16. Cell Phone
18. Nature or Purpose of Organization
20. Percent of Members Residing in the Great Neck Park District
22. Approximate Size of Group Expected
24. Description of Activity and Program to be Presented
26. List Meeting Dates
    List Dates with Same Setup
28. Start Time
    Start Time
29. End Time
    End Time
33. Request to Use Park District Equipment
35. Equipment

    1. Chairs Presentation Style
    2. Chairs Around Tables
    3. Chairs in a Circle

    1. Microphone
    2. Podium
    3. Coffee Pot (Park District does not apply coffee, cups, napkins, plasticware, sugar or milk)
37. Regulations
    - Facility requests will be granted based on room availability.
    - Groups are expected to respect other groups using the facility at the same time. Groups not showing respect for other groups may lose the right to use space at Great Neck House.
    - In consideration of use of the Great Neck House facilities, each organization or group agrees that it will pay for damages to any property of the Great Neck House resulting directly or indirectly from the conduct of any member, officer, employee or agent of the organization or group, or any of its invitees, and that it will save harmless and indemnify Great Neck Park District for any injury to persons or property caused by the organization or any other person in connection with the program.
    - It is understood that the Great Neck Park District assumes no responsibility whatever for any property placed in Great Neck House in connection with any program, and that the Great Neck Park District is hereby expressly released and discharged from any liability for any loss, injury or damage to persons or property which may be sustained during or by any reason of a program held on the Great Neck House premises.
    - The Great Neck Park District reserves the right to charge groups for the use of the Great Neck House. Groups will be notified of any fee to be charged.
    - Applications should be submitted at least 14 days prior to the event.
    - Please inform Great Neck House of any cancellations at least 24 hours prior to event. Groups that do not notify Great Neck House in the event of a cancellation may have use of facility privileges suspended.
    - The Great Neck Park District reserves the right to cancel any permit based on scheduling conflicts that may arise.
    - The Great Neck Park District reserves the right to deny ant requests as deemed necessary.
    - Please watch Cancellations.com for building closures due to inclement weather.
41. Date
    Date
42. Facility Available

    1. Yes
    2. No
44. Application Received On:
45. Application Processed By:
47. Rec Trac Reservation ID
48. Fee Required

    1. Yes
    2. No
49. Fee Amount
51. Can Not Provide the Following Items
55. Approvals
57. Facility Supervisor
58. Superintendent
60. Board of Commissioners
62. Chair
63. Treasurer
64. Secretary
68. Facility Denial
70. Reason for Denial
72. Facility Supervisor
73. Superintendent
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75. 1. Receive an email copy of this form.
76. Email address

    This field is not part of the form submission.

77. Submit

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