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Welcome to the
Queen Anne's County 4-H Park

The Crown Jewel of ourAgricultural Heritage

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Application for Use of Park Facilities

Name of Organization

Contact Name

Address

Phone

Email

Description of Event

Who will Benefit from Event

Date(s) Requested

Start and End Times

Will Alcohol be sold at your event?

Have you obtained a liquor license?

Facilities/Area of Grounds requested:

Exclusive Use of Park @ $500/day

Main Hll Only @ $150/day

Main Hall & Shooting Range @ $200/day

Main Hall & Kitchen @ $225/day

Kitchen Only @ $75/day

Kitchen & Dining Hall @ $150/day

Dining Hall Only @ $75/day

Meeting Room Only @ $50/day

Commercial Building #1 @ $50/day

Main Pavilion @ $50/day

Horse Ring & Stables @ $200/day (manure/bedding must be removed)

Other Barns $50/day (manure/bedding must be removed)

Check barns requested:

Beef Barn ($150)

Swine Barn

Dairy Barn

Picnic Pavilion

BBQ Pavilion

Rabbit/Poultry Barn

Crops Pavilion

Goat Barn (April - October Only)

Sheep Barn

By signing this form, I acknowledge that I have read and undestand the regulations and rules as listed on the "Instructions for Rental and Use of the 4-H Park Facilities". I understand that Exclusive Use of the Park does not include the Wilson Building bathroom & showers, Commercial Building #2, Mulch Storage area at back of Main Pavilion, or the Agricultural/Farm Museum building and grounds. Additionally, the Goat Barn is only rented from April - October. I understand that my request is not verified until confirmed by the Scheduling Secretary, and all documentation and fees have been collected.

To reserve the QAC 4-H Park under the 4-H Banner, an event must be directly hosted by the 4-H program or a chartered club. QAC 4-H holds a general liability policy that covers such events, including youth, volunteers, and spectators. That coverage does not extend to events being hosted by other organizations who may be sharing/donating profits to a club, therefore, those entities must reserve the Park themselves and provide a certificate of insurance to the QAC 4-H Park Board of Directors. In addition, it is highly recommended that sponsors of high-risk activities such as horse riding and shooting sports clubs seek additional insurance coverage. Please connect with your County Extension Agent to discuss options.

Signature

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