Event Date

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The applicant/sponsor agrees to indemnify and hold harmless the Village of Tarrytown (Vllage) and the Village Police Department from any and all claims and judgments for personal injury or damage to property resulting, directly or indirectly, from the activities in connection with which the permit is issued, and from any costs and expenses to which the village may be subjected or which it may suffer or incur by reason thereof. The applicant/sponsor agrees to comply with the pertinent provisions and rules of the Village, the specific terms and conditions of the permit, and to all applicable County, City, State and Federal laws, rules and regulations. The applicant/sponsor agrees to hold the permit in their possession at the time and site of the event, as well as any other permits for the event required by the Village or any governmental agency. The applicant/sponsor agrees to pay the fees, if any, associated with the subject special event. The applicant/sponsor agrees to the responsibility for the procurement of and payment for any electrical energy used during the event. The applicant/sponsor agrees to the responsibility of clean-up and restoration of the site after the event and the cost of any village employee overtime incurred because of an applicant/sponsors failure to clean and/or restore the site following the event will be borne by the applicant/sponsor. The applicant/sponsor agrees to confine their activities to the locations and times specified in their permit and any guidelines established by the Village Administrator for certain designated parks or park locations. Please note: Penalty for Falsifications: Falsification of Any Statement Made Herein Is an Offense Punishable by a Fine or Imprisonment or Both.

Please upload a hard copy signed acknowledgement (notarized)

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