Camp Denison       84 Nelson Street, Georgetown, MA. 01833                     978-352-5744

APPLICATION AND PERMIT TO USE CAMP DENISON

Applicant & Organization:

Addresses of Applicant & Organization:

State:                        Zip:                                                                 Phone:

Number of Persons in Party:

Dates of Use:                                              Hours:

Rain Date:

Facilities Desired: (Lodge, Rest Rooms, Camp Site, etc)

Intended Use:

Name of Emergency Contact Person:                                                  Phone # of Emergency Contact Person:

The Following are the Rules and Regulations of Camp Denison:

¨ Large Groups (Over 15 Persons) Require A Permit Issued By The Custodian.

¨ Hours of Operation: Daylight Hours Unless Otherwise Permitted

¨ Trash - Bring Your Own Bags. Deposit All Trash Contained In Bags InCamp Dumpster. 

  No Loose Waste Allowed.

¨ Camp Denison is a Drug, Alcohol, & Tobacco Free Facility

¨ Fishing is Permitted in Accordance with State Laws. A Massachusetts Fishing License is  

  Required.

                                                                                 FEES

Fees: Make Check Payable To The Town of Georgetown.

Day Use of Conservation Grounds: No Charge

Non Profit Groups: Camp Site, Overnight/Night $2.00/ camper.

Lodge: Day Use/Day $20.00

Lodge: Overnight Use/Night: $20.00 each night

Small Private Groups: Lodge: Day Use (6 hours). $30.00 for the first 30 people and $2.00 for each additional person.

Groups Are Required To Clean The Rest Rooms, Lodge (if used) and the Outside Grounds Prior To Departure.

(The Camp Denison Committee reserves the right to modify or waive the above based upon individual circumstances if considered in the best interests of the Town.)

The Following Are Prohibited at All Times:

· Loud or Disturbing Behavior.

· Alcoholic Beverages, Intoxication or Possession or Use of Illegal Substances.

· Non-permitted Open Fires.

· Unleashed Pets

· Dumping or Leaving Trash or Other Materials Anywhere on the Property.

· Destruction or Marking of Any Camp Denison Property Including, but Not Limited to Buildings,

  Bridges, Railings, Benches, Tables, Signs, Markers, Trees and Vegetation.

· Hunting, Trapping, and the Possession or Discharge of Firearms.

· Harassing or Disturbing of Wildlife by Visitors, or Their Pets.

· Off-Road Motorized Vehicles.

· Swimming.

Additional Conditions Agreed To:

The Town accepts no liability with respect to any claims which might arise out of the users activities and the user holds the Town harmless accordingly.

Agreement by the Applicant:

If any portion of this permit is breached, those parties involved will be held personally responsible for all and any cost for cleaning or repairs that may result.

By accepting this permit, the applicant and all named parties have agreed to abide by all rules, regulations and conditions. It is the responsibility of the applicant to inform all members of his her party of said conditions:

___________________________________________________                        ________________

               (signature)                                                                                                          (date)

Committee Acceptance:

The Members of the Camp Denison Committee do hereby issue this permit to ____________________ for the above-mentioned use at Camp Denison on _________________ and rain date of _______________ .

This Permit to expire on __________________________.

Camp Denison Committee Authorization: