Black River, NY · Jefferson County
Facilities Use Application
This application lets individuals and organizations request use of Village of Black River facilities and describe their planned activity.
What this form is
Use this application to request a Village facility for a planned activity, selecting the facility and providing the requested date and hours. It asks for the applicant’s contact and organization details, a brief activity description, and whether a certificate of insurance is provided. Applicants also agree to clean up and return the facility or grounds to their original condition.
Who needs it
Individuals or organizations seeking to use a Village of Black River facility can complete this application with their event details.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This application is signed without a notary; the signer agrees to the responsibility statement and signs the form.
How to submit this form
- 1
Download The Application
Download the Facilities Use Application PDF.
- 2
Complete The Form
Enter your contact and organization details, requested date and hours, facility selection, and planned activity.
- 3
Indicate Insurance Status
Answer whether a certificate of insurance is provided.
- 4
Sign And Submit
Sign the responsibility statement and submit the application to the city department named on the form.
Frequently asked questions
- What facilities can I request?
- The application lists the Municipal Offices Meeting Room, Maple Street Park, Maple Street Recreation Building, Maple Street Pavilion, and an option to specify another facility.
- What details does the application ask for?
- It asks for your name, organization, telephone number, requested date and hours, facility selection, certificate of insurance status, and a brief description of the planned activity.
- Do I need a notary for the Facilities Use Application?
- No. This application is signed without a notary; the signer agrees to the responsibility statement and signs the form.
- How do I submit the Facilities Use Application?
- Submit it to the city department named on the form; check the city website for current contact details.