Chestnuthill Township Park Pavilion



Request for use of Facility

$30 Fee (Check or Money Order only)

Complete and submit this form if you wish to use the 
Township Park Pavilion facility for your function.

Contact Bernie Kozen at 570-992-9733 for more information

 
 

 Please read the rules and regulations of the park before below submitting a request to reserve your slot.

  
 
     

 Name of Group or Individual

 Your Address
 Street
 City, St, Zip
 
 Phone (Daytime)
 Contact Person  

 Approximate # of People Expected (Room Maximum is 100)

 Date(s) Requested

 Time(s) Requested

 I agree to the rules and regulations of the park building and take full responsibility for the actions of the above group or organization

 Your Name
 Your Position in the Group/Organization

   
     
 

     Pavilion Use Rules & Regulations

  1. Picnic tables and other park items are not to be removed from the pavilion.
  2. Groups who have reserved the pavilion have priority over groups who have not reserve the pavilion.
  3. Groups are to only use the pavilion to which they are assigned.
  4. Fields and play areas are to be shared.
  5. Trash and litter must be placed in the proper containers.
  6. Park rules and regulations as outlined in Ordinance 96-1 must be obeyed.
  7. Open fires are prohibited Use of personal grills is permitted.
  8. Pets are NOT allowed.
  9. The park is a drug free zone. Smoking and alcoholic beverages are prohibited.
  10. The Township has the right to enforce these rules.
  11. The Fee for the use of a pavilion is $30.

     Thank you for you cooperation,

   The Chestnuthill Township Supervisors 
   The Chestnuthill Township Park Committee

    

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