Nyack, NY · Rockland County
Park Usage Permit Request
This agreement lets residents and other applicants request permission to hold a gathering or event at Memorial Park or another listed Village of Nyack park area.
What this form is
The Village of Nyack uses this request and agreement for park use; groups of 10 or more require a permit, and groups of 40 or more require Village Board approval. Applicants identify the requested park area, dates, times, activity, equipment, and attendee count, and agree to park rules and responsibilities. The checklist also calls for a signed liability release and rules agreement, a refundable security deposit, a certificate of insurance, and a driver's license copy.
Who needs it
Anyone seeking a permit for a gathering of 10 or more at Memorial Park should complete the request; groups of 40 or more require Village Board approval.
How to submit it
Sign, date, and return the request to the Village Clerk’s Office, 9 North Broadway, Nyack, NY 10960.
About notarization
This agreement is signed and dated without a notary; the form also requests a certificate of insurance, a driver's license copy, and signed liability and rules agreements.
How to submit this form
- 1
Download The Request
Download the Park Usage Permit Request PDF.
- 2
Complete The Agreement
Provide applicant details, requested park area, dates and times, activity information, and attendee count; review and sign the agreement.
- 3
Gather The Checklist Items
Prepare the signed liability release and rules agreement, refundable security deposit, certificate of insurance, and driver's license copy.
- 4
Return It To The Village
Sign and date the request, then return it to the Village Clerk’s Office, 9 North Broadway, Nyack, NY 10960.
Frequently asked questions
- Who needs a Park Usage Permit Request?
- The form is for applicants seeking permission to use a Village park. The rules say groups of 10 or more require a permit; groups of 40 or more require Village Board approval.
- What attachments are listed on the application checklist?
- The checklist calls for a signed liability release and rules agreement, a refundable security deposit, a certificate of insurance, and a copy of the applicant's driver's license.
- Do I need a notary for the Park Usage Permit Request?
- No. The agreement is signed and dated without a notary. It requests a certificate of insurance, a driver's license copy, and signed liability and rules agreements.
- How do I submit the Park Usage Permit Request?
- Sign, date, and return it to the Village Clerk’s Office at 9 North Broadway, Nyack, NY 10960.
Need something notarized?
This Park Usage Permit Request doesn’t need a notary — but if you have another Nyack form that does, a commissioned online notary can help.