Do I need a notary for the Park and Gazebo Use Request Form?

No. This document does not require notarization; sign and date the hold-harmless agreement. Organizations must also provide a certificate of insurance.

How do I submit the Park and Gazebo Use Request Form?

Return the completed form to the Office of the Village Clerk at 52 South Parkway, PO Box 203, Leicester, NY 14481. The $50 security deposit is payable to the Village by check.

Does submitting the form guarantee approval?

No. The form states that gazebo use is granted by Village Board approval, and the Village Board records approval or denial.

What does an organization need to provide?

The document requires organizations to provide a certificate of insurance with $1,000,000 per occurrence in insurance limits and sign a hold-harmless agreement.

Leicester, NY · Livingston County

No notary required

Park and Gazebo Use Request Form

Leicester residents and nonresidents use this form to request Village Park or gazebo space for an event and provide event and contact details.

What this form is

The form requests use of the Village Park or gazebo and asks for the event date, time, description, responsible person’s contact information, and resident status. Village Board approval is required. Residents and nonresidents must sign a hold-harmless agreement; organizations must provide a certificate of insurance and sign an agreement. A $50 security deposit, payable by check, is required before the event.

Who needs it

Residents, nonresidents, and organizations planning an event at the Village Park or gazebo should complete the request form.

How to submit it

Return the completed form to the Office of the Village Clerk, 52 South Parkway, PO Box 203, Leicester, NY 14481. The form states that the $50 security deposit is payable to the Village by check.

About notarization

This document is signed without a notary; sign and date the hold-harmless agreement, and organizations must also provide a certificate of insurance.

How to submit this form

1
Download The Form
Download the Park and Gazebo Use Request Form.
2
Complete The Request
Provide resident information, event date and time, event description, and the responsible person’s contact details.
3
Gather Required Documents
Sign the hold-harmless agreement. Organizations must provide a certificate of insurance.
4
Submit To The Village Clerk
Return the completed form to the Office of the Village Clerk at 52 South Parkway, PO Box 203, Leicester, NY 14481.

Frequently asked questions

Do I need a notary for the Park and Gazebo Use Request Form?: No. This document does not require notarization; sign and date the hold-harmless agreement. Organizations must also provide a certificate of insurance.
How do I submit the Park and Gazebo Use Request Form?: Return the completed form to the Office of the Village Clerk at 52 South Parkway, PO Box 203, Leicester, NY 14481. The $50 security deposit is payable to the Village by check.
Does submitting the form guarantee approval?: No. The form states that gazebo use is granted by Village Board approval, and the Village Board records approval or denial.
What does an organization need to provide?: The document requires organizations to provide a certificate of insurance with $1,000,000 per occurrence in insurance limits and sign a hold-harmless agreement.

Need something notarized?

This Park and Gazebo Use Request Form doesn’t need a notary — but if you have another Leicester form that does, a commissioned online notary can help.