Loading...
SPORTS AND PROGRAM CO-SPONSOR AGREEMENT (18) CITY OF CLEARWATER SPORTS AND PROGRAM CO-SPONSOR AGREEMENT THIS AGREEMENT, made and entered into this 29 day of September_, 2Q20 by and' between the CITY OF CLEARWATER, FLORIDA, a municipal corporation of the State of Florida, herein referred to as "City", P,O. Box 4748, Clearwater, FL 33758 and the Clearwater Aquatic Team herein after referred to as "Co-Sponsor Group" 1501 N. Mcher Road, Suite 229,Clearwater, FL 33765 (add rens} WITNESSETH: WHEREAS, the Co-Sponsor Group is an organized recreational group or program approved by the Parks and Recreation Director, which provides its own volunteer leadership and administration; and WHEREAS, the City recognizes the Co-Sponsor Group as providing a valuable service to the community, through their extensive use of volunteers and volunteer resources, and WHEREAS, the Co-Sponsor Group meets all of the criteria included in this Agreement, and WHEREAS, the Go-Sponsor Group desires to use various City-owned, facilities for organized sports programs and or various other recreational related activities for the citizens of Clearwater; and WHEREAS, the City owns certain public properties and facilities that are available to be utilized by the Co-Sponsor Group for their programs; and WHEREAS, the Co-Sponsor Group may use the physical facilities owned and maintained by the City or leased to the City subject to the terms of this Agreement, NOW, THEREFORE, in consideration of the covenants herein contained and other good and valuable consideration, the City agrees to allow the Co -Sponsor Group to utilize City facilities as described in Exhibit "J" attached hereto, as may be amended from time to time, and is hereby made a part of this Agreement, under the following terms and conditions- 1 Recitals, The foregoing recitals are true and correct and are incorporated in and form a part of this Agreement. I I P a 2. The term of the Agreement will be for a period of one (1) year commencing October 1, 2020 and ending September 30, 2021 3. The Co Sponsor Group agrees to abide by and enforce all City ordinances as they relate to Parks & Recreation. The ordinances can be found at: https://Iibra[y.municode,com/fl/clearwater/codes/c--odle of ordinances 4. This Agreement may only be amended by written amendment to this Agreement, executed by both Parties. 5, This Agreement will remain in effect unless terminated by either party as follows: I a. Upon breach of this Agreement by a party, the other party will give written notice of termination of this Agreement specifying the claimed breach and the action required to cure the breach. If the breaching party fails to cure the breach within five days from receipt of said notice, then the contract will terminate ten days from receipt of the written notice. b. Either party may terminate this Agreement without cause by giving written notice to the other party that the Agreement will terminate 30 days from the receipt of said notice by the terminating party. & Subject to available funding, the City will provide and maintain facilities for the Co - Sponsor Group for their approved program and activity. The City of Clearwater Parks and Recreation Department is dedicated to improving the overall quality of sports and athletics in the City and reserves the right to close any field, at any time, for any reason, in its sole discretion, including but not limited to, for maintenance purposes or poor field conditions. T. Any unpermitted use of a facility or field may result in fees, and or immediate termination of present and/or future field use. Individual teams or participants using closed facilities will be considered representatives of the Co-Sponsor Group in which they participate. 8. The Co-Sponsor Group agrees to provide recreational programs and activities to primarily benefit the residents of Clearwater. The City will actively promote the Co- Sponsor Group programs and activities utilizing City resources i.e. my Clearwater Magazine, C-View, etc. Promotional materials must be approved by eity liaisom before distFibution . camps, elinies, tournarments, etc.). Any 151 ullibublial hiatelials using it e tu, Y OT ClearROlva er ogo must recevewritt n approval prior to distribution. 2 1 V) a g 9. The City of Clearwater complies with the Americans with Disabilities Act of 1990, Public Law 101-336, July 26, 1990 (42 USCA § 12101) ("ADA"), which prohibits discrimination on the basis of disability, The ADA, as applied to cities, counties, and other local governmental entities, requires that no qualified individual with a disability shall, on the basis of a disability, be denied the benefits of local government services, programs, or activities. The Co-Sponsor Group acknowledges the importance of complying with the ADA and agrees to educate itself and its members of all requirements of the ADA and will abide by same. 10. The Co-Sponsor Group shall not discriminate on the basis of race, creed, color, age, national origin, religion, sex, disability or any other protected class in accordance with current state or federal laws. The City reserves the right to terminate this Agreement. immediately upon breach of this covenant. 11. The Co-Sponsor Group shall maintain legal status as a state or federal Internal Revenue Service approved 501(c)(3) organization. Such status shall be maintained during the term of this Agreement and proof of this status shall be submitted to the City annually. If 51(c) (3) status is rescinded, suspended, cancelled, or otherwise changed, the Organization shall notify the City within thirty (30) days. Failure by the Organization to maintain such status shall be cause for immediate termination. 12. The Co-Sponsor Group agrees to provide competent leadership for the program. The Board of Directors, as established by the organization's by-laws, will include at minimum, one (1) City of Clearwater resident. The Board of Directors will conduct the program in the best interest of the City of Clearwater, 13, The Co-Sponsor Group agrees to provide recreational programs and activities to primarily benefit the residents of Clearwater. The Co-Sponsor Group agrees to promote their program to the citizens of Clearwater and that a minimum of 50% of their participants will be residents of the City of Clearwater. If the 50% target is not being satisfied, the Co-Sponsor Group may submit a plan to achieve this goal or an alternative that must be approved by the City. Failure to maintain fifty percent (50%) resident participation may be cause for termination with thirty (30) days' notice, if a viable plan to increase resident participation is not approved by the City. 14. The Co-Sponsor Group agrees to submit the following as specified, and if apprepriate as outlined in eEffespending Exhibits. Failure to comply with this .......it" IMMM, fif lVttti;t VtfMdNffl'rb­_Zj.-11— tightm Ma, G. termination of present and/or future field use, or termination of current co- sponsor agreement. a. The Co-Sponsor Group will provide the following information each year as outlined in Exhibit A. • Specific range of dates for their primary season and registration dates. • Request the facilities and/or fields for their primary season Request any special event dates such as tournaments, clinics, camps, fundraisers, etc. Charges will be determined per the agreement. b. Current roster as defined in Exhibit J. Due Date: or as defined in Exhibit J. • Rosters must include the following: 0 Name of participant 0 Participant's home address 0 Participant's date of birth 0 Parent/Guardian Name 0 School Attending C. Payment for participants who do not have valid participant cards. Due Date- or as defined in Exhibit J. • Each participant is expected to possess a current City of Clearwater Recreation Card, The card must be valid for at least 50% of the Co-Sponsor Group's season as outlined in Exhibit J. A fee will be accessed to the organization for each member determined not to have a current City of Clearwater Recreation Card, regardless of whether the individual is a City of Clearwater resident or non -resident. 0 Current fees are as follows: $128.40 for recreational %V 1,14.vv RA WHIPtflUt[Vt� Or as outlined in Exhibit J. 4 1 P • If a player does not have or purchase a Recreation Card, the fee charged to the organization will include tax. The organization is acting as a conduit for the individual and as such is responsible for the tax portion of the Recreation Card purchase, • Roster payments must be accompanied with a Participant Card Application for each person without a valid Recreation Card. See Exhibit K. • This fee is subject to change as defined in Clearwater Code of Ordinances, Appendix A - Schedule of Fees, Rates, and Changes,- XI Parks, Beaches, Recreation - Use of Facilities by nonresidents (ch 22). • It is recommended that the Co-Sponsor Group retain a copy of the participant's recreation card or a copy of the recreation card receipt, d. An accurate facility and/or fieldschedule for approved season, depicting actual use. See Exhibit J. e. A complete list of current Board of Directors: Due date: 10/15/2020 f. A list of all coaches and their certifications and proof of required Level 11 or City approved equivalent background checks. See Exhibit C & J. g• Copy of by-laws: Due date: 10/15/2020 h. Verification of non -profit status: Due date: 10/15/2020 i. A copy of Insurance Certificate naming the City of Clearwater and the Pinellas County School Board as additionally insured, and waiver, if applicable. See Section 16 for coverage requirements: Due date: 1/1/2021 or as needed See Exhibit H for Insurance Exemption Form j. DR-14 (tax exemption form), if applicable- 12/1/2020 k. Annual financial statement: Due date- 11/1/2020 See Exhibit I for template of minimal requirements. .......................... _Anaiial-Luopn4a�y-R-"I*............ Submitted at the end of the approved season, • See Exhibit G for template and due date. 5 l P a M. Submit nomination for Excellence in Youth Sportsmanship Award- Due date: 12/31/2020 n. Copy of concessions manager certification, if applicable: Due date: NJA 0. Emergency Action Plan for each facility used during season: Due date. 10/15/2020 See Exhibit IF for Emergency Action plan template, 15, The Co-Sponsor Group agrees that it will indemnify and hold harmless the City, its officers and employees from liabilities, demands, damages, losses, and costs to the extent caused by the negligence, reckless, or intentionally wrongful conduct of Co- Sponsor Group, staff, volunteers or agents, or on account of any unsafe condition that may exist as a result of the negligent operation by Co- Sponsor Group, staff, volunteers or agents of the facilities. 16. The Co-Sponsor Group further agrees to carry at its own cost and expense, acquire and maintain during the term with the City, sufficient insurance to adequately protect the respective interest of the parities. Specifically, the Co- Sponsor Group must carry the following minimum types and amounts of insurance on an occurrence basis, or in the case of coverage that cannot be obtain ed on an occurrence basis then, coverage can be obtained on a claims,- made basis with a minimum three (3) year tail following the termination or expiration of the Agreement. These insurance requirements shall not limit the liability of the Co-Sponsor Group. The City does not represent that these types or amounts of insurance to be sufficient or adequate to protect the Co -Sponsor Group's interests or liabilities, but are merely minimums: a. Comprehensive General Liability insurance on an "occurrence" basis including but not limited to bodily injury, personal injury, and property damage with limits not less than $1,000,000 per occurrence, $2,000,000 aggregate. b. Automobile Liability insurance for any motor vehicle owned by, hired by, used by, or used on behalf of the Co-Sponsor Group, providing Bodily Injury Liability and Property Damage Liability covering any injury or damage with limits no less, than $1,000,000 per occurrence, $2,000,000 aggregate. If the Co-Sponsor Group does not own, any motor vehicles or Figi:5 City rope 59 the Uigffi or group travel, this insurance is not required. C. The City recommends but does not require the following coverages to protect the Co-Sponsor Group. The City is not liable and shall be 6 1 Fla g e indemnified against any claims arising from any claims made against the recommended coverages provided below, i, Property Insurance ii. Crime and Employee Dishonesty Coverage iii, Sexual Abuse & Molestation Coverage iv. Workers Compensation Coverage v. Employers Liability Insurance ADDITIONAL INSURED: The City is to be specifically included as an additional insured on all liability coverage described above except for the Workers' Compensation coverage. OTHER INSURANCE PROVISIONS: The General Liability and Automobile Liability policies are to contain, or be endorsed to contain, the following provisions: 1, PRIMARY INSURANCE COVERAGE: For any claims related to this Agreement, the Co-Sponsor Group's insurance coverage shall be primary insurance as respects the City, its officers, officials, employees, and volunteers, Any insurance or self-insurance maintained by the City, its officers, officials, employees, or volunteers shall be excess of the Co- Sponsor Group's insurance and shall not contribute to it. 2. RIGHT OF RECOVERY: Except for Workers' Compensation, the Co- Sponsor Group waives its right of recovery against the City, to the extent permitted by its insurance policies. CERTIFICATE OF INSURANCE/CERTIFIED COPIES OF POLICIES: The Co- Sponsor Group will provide the City with a Certificate or Certificates of Insurance showing the existence of coverage as required by the Agreement. In addition, the Co -Sponsor Group will provide to the City, if asked in writing, certified copies of all policies of insurance. The Co-Sponsor Group will maintain the required coverage with a current Certificate or Certificates of Insurance throughout the term of the Agreement with the City. New certificates and new certified copies of policies slid'! be provided to tI ie C ity wl jei ievei ai ty policy is renewed, revised, or .......... ................- ....... rers. I ne aaaresew here such ceilificafes an certified policies shall be sent or delivered is as follows- 7 1 P City of Clearwater Attention: Athletics Office 1160 Seminole Street Clearwater, FL 33755 And City of Clearwater Attention: Risk Manager 100 S. Myrtle Ave, Clearwater, FL 33756 17. The Co-Sponsor Group, will maintain a positive relationship with the City and Parks and Recreation, Department by: a. Obtaining prior approval for any activities, b. Obtaining prior approval for any field or facility improvements. C. Providing all requested information and paying all fees on time. d. Informing Parks and Recreation staff of field problems or schedule change requests in a timely manner, e. Enforcing and abiding by all applicable laws, rules, policies and procedures. f. The Co-Sponsor Group President will be the liaison with the City unless the President appoints another representative. g. The City and the Co-Sponsor Group will make a good faith effort to reply to all communications (phone, e-mail, etc.) within two (2) business days, 18. The Co-Sponsor Group will act as a good caretaker and custodian of all City of Clearwater property by avoiding any activity that may damage the facilities, by cleaning up trash after each use, by enforcing the "no smoking" policy, by 1 itilizing I ig hts on ly who n needed 2 nd tt i rn i ng them off afte r i-,S_Q_ 19. The Co-Sponsor Group will assume all responsibility to monitor storm conditions and evacuate playing, fields of participants and spectators when the threat of lightning or dangerous conditions approaches. Co-Sponsor Group will cancel 8 i P a g e games when field or playing conditions could cause harm or damage to participants or to the facilities i.e. flooded fields. 20. The Co-Sponsor Group will validate the quality of adult leadership by conducting and authorizing annual Level 11 or City approved equivalent criminal background checks, on all persons acting as a coach, and any person acting in an official capacity with any organization directly overseeing the Co-Sponsor Group's youth activities. These checks, shall be conducted and completed prior to the beginning of each playing season or involvement with children and shall remain valid for the duration of this agreement, The Co-Sponsor Group shall employ a reputable company to conduct such checks. A statement confirming the completion of the background checks is due to the Athletics Office prior to the first day of utilization of any City facility hereunder. Co-Sponsor Group is responsible to notify the City of any persons acting, in an official capacity with the organization added during the season or after initial form was provided. Said individuals shall undergo the criminal background check and a notarized form must be provided for each individual added. The Co-Sponsor Group shall also adopt and publish a criminal background check policy to be used for determining an individual's eligibility to coach. Should an individual be disqualified as a result of the check, the Co -Sponsor Group will prohibit that individual from serving in any official capacity with the Co-Sponsor Group's activities, disqualify that individual from providing any services or participating in any activities contemplated under this Agreement, and notify the City of said applicant disqualification. The Co-Sponsor Group shall establish a policy as to how its criminal background checks will be processed and will pay for the cost of each background check. Exhibit "C" — Criminal Background Investigation: Policy is shown as a base required for the Co-Sponsor Group. The Co-Sponsor Group shall furnish to the City a listing of the persons that have successfully undergone a Level11 or City approved equivalent criminal background check prior to the beginning of any individual's involvement with any youth related activities. A Co-Sponsor Group Board member and Notary Public shall sign this listing for final verification of the actions taken by the Co-Sponsor Group. 21. Volunteers under the age of 18 must be approved by the Co -Sponsored Group in advance. A written list of all qualified volunteers under the age of 18 must be submitted to the City prior to use of volunteer. a. Minors may access the facility but only in the presence of an approved coach. b. Minors cannot supervise other minor participants of the program. 22. The Co-Sponsor Group will recognize and support City publlic/private partnerships. The Co-Sponsor Group will be given ample notice of such partnerships and their responsibility if any. 23. The Co-Sponsor Group must receive prior written approval from Parks and Recreation to make any alterations, changes or additions to the existing facilities. The Co- Sponsor Group is responsible for submitting a facility improvement request form for review/approval. 24. The Co-Sponsor Group is not permitted to operate a concession stand when an outstanding City agreement is in place. The Co-Sponsor Group will not engage in private third-party operations of the concession stand. In the absence of an outstanding City agreement, the Co-Sponsor Group is permitted to operate a concession stand. The Co-Sponsor Group will also be responsible to, maintain the concession stands to the standards establiished by the State of Florida Department of Health and the City of Clearwater as outlined in Exhibit B. Any Co-Sponsor Group that operates a concession stand will be required to have their concession manager become a Certified Professional Food Manager. As regulated by the Florida Department of Health, food service operations, must provide annual training for employees. It is the responsibility of the certified manager or person in charge to train or ensure the training of all employees under their supervision and control who engages in the storage, preparation, or serving of food, or cleaning of equipment, utensils, or food contact and non -food contact surfaces, and to do so in accordance with acceptable sanitary practices. The trainings must be annual and provided to employees by March 31 of each year. Employees hired after the annual training has been provided for that calendar year must receive training within 30 days of being hired. The certified manager or person in charge must also maintain a copy of the establishment's most recent regular food service inspection form provided by the department. Employees shall present this inspection form to guests or patrons for their review Opul I I eqoest. 25. Facilities constructed by the Co-Sponsor Group i.e. press boxes, concession stand, batting tunnels etc., will be maintained by the Co-Sponsor Group. Failure to maintain these facilities in a manner acceptable to the City shall be a material 10 1 P breach of this Agreement and may result in the termination for cause of this Agreement. 26. Schedules submitted by the Co-Sponsor Group must accurately depict field/facility use and any changes must be approved before they are implemented. The City reserves the right to revise or revoke schedules of facilities based on inappropriate use or non -use by the Co-Sponsor Group. The City also has the sole right to assign fields or facilities to others if use by the Co- Sponsor Group is not substantiated. 27. The Co-Sponsored Group will be responsible for all tournament fees for any tournament. Any other events including fundraising events or activities will be charged per the Athletics Office fee schedule. The Co-Sponsored Group will be responsible for all facility fees for any non -sponsored seasons. Th e Co- Sponsored Group will be responsible for all facility fees for any camps/clinics when registration fees are required to participate. The Co-Sponsored Group will be responsible for direct City costs for any camps/clinics open to the public and free to participate, 28. Any revenue collected by the Co-Sponsor Group on City property must be used to promote and support the Co-Sponsor Group's activities, Use of funds for other purposes could result in termination of this Agreement, 29. The Co-Sponsored Group agrees that all staff, coaches, volunteers and agents of the Co-Sponsored Group shall conduct themselves as good role models exemplifying good sportsmanship, cooperation and appropriate behavior. The City reserves the right to require removalof any person associated with the Co- Sponsored Group if he/she is deemed to be exhibiting behavior detrimental to overall success of the organization or City, 30, The Co-Sponsor Group and all its invitees will abide by all appl'icabl'e law s and all City policies when using City facilities, including those policies which state that the consumption of tobacco products or alcoholic beverages on City or School property is prohibited. 31. The Co-Sponsor Group further agrees to make no unlawful, improper, or offensive use of the facilities. 32. If either party terminates the Agreement, any improvements made to the property by the GO-SPORsoF GFOUP Will remain the property of the eity. 33. The Co_sponsor Group may not assign this Agreement or any of its rights hereunder, nor permit others to use the facilities or any part thereof without the written consent of the City. The Co-Sponsor Group shall not permit any third- 11 party usage. This Agreement is a privilege for the benefit of the Co-Sponsor Group only and may not be assigned in whole or in part by the Co-Sponsor Group to any other person or entity. Any attempt to assign the rights or obligations of this Agreement shall render this Agreement null and void in total, The Co-Sponsor Group understands that the Co- Sponsor Group's use of the facilities is inonexclusive, 34. Use of facilities by the Co-Sponsor Group is intended solely for the purpose of training and competition for the Co-Sponsor Group's rostered participants. Any personal use by volunteers is prohibited 35. Any vendor sales (merchandise or concessions) must be approved in writing by the City of Clearwater Athletics Office prior to the event, 36. Co-Sponsor Groups are responsible for informing their members of current guidelines and rules as outlined in this Agreement. Organizations are expected to take reasonable measures to ensure compliance during their events. Violations may result in the suspension or cancellation of this Agreement. 37. Any questions arising out of the use of the facilities or otherwise arising under this Agreement must be submitted in writing. 38. Special conditions or other issues (i.e. maintenance issues, payment of fees, special needs) will be covered in Exhibit(s) and attached hereto and made a part hereof. 12 11= a g El, IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first written. Witnesses: As to City Manager or Designee As to Co -Sponsor Group President Designee/City Liaison By: By: CITY OF CLEARWATER, FLORIDA City Manager or Designee Co -Sponsor Group President or Designee 13IPage EXHIBIT A City of Clearwater Co-Sponsor GroupPrimary Season Use Request DUE DATE: Ce-Spenser Group: Specific Range ref Dates for Primary Season: Requested Facility/Field Primary Season: Requested Special EventDates (Tournaments, Clinics,Camps, Etc.). Chargeswill be determined per agreement. D Submitted By. Date: 14 for a changing of the locks must be submitted to the Athletics Office in writing. Additionally, no improvements (painting, signs, etc.) can be made at any building without prior written approval by the Parks and Recreation Athletics Office. Any unauthorized hanging of signs will result in their removal and the organization will be billed for the labor and any resulting damage. The Co -Sponsor Group shall provide keys/access to any shed or equipment stored at or on city property. E. The Co -Sponsor Group may be required by the City of Clearwater Parks & Recreation Department to remove all stored materials following the completion of the season so another user group may use the area. The user is responsible for keepingthe storage area ;in_good__condition anti- nust=_meet-all OSHA ,or applicable regulations for storing materials. Violations of these rules may result in the user losing the use of the storage area. F. The Co -Sponsor Group is required to maintain the cleanliness of the office and common conference room area and any storage room assigned to the organization. All records relating to the organization (registration forms, medical releases, etc.) shall be kept in a secure office or secure cabinet, not the general conference room. The common room must be cleared of all organizational paperwork, equipment, etc. at the end of the season. Rooms designated to Co - Spon sor o-Sponsor Group during approved season: Room/Space Duration of use CAT Office at the Long Center October 2020 • September 2021 The undersigned acknowledges receipt of this document. Contact/Representative: Date; 1c' / °..) 16IPage EXHIBIT B City of Clearwater Concession Stand & Office Building Policies & Procedures City of Clearwater Parks and Recreation Department permits various organizations, groups, and agenciesto use the concession/storage/office building on property owned by the City of Clearwater. Permission to use City of Clearwater property and/or facilities shall be based on the following conditions: A. The use of the property and/or facilities shall be on a seasonal basis rather than a permanent one. For example, a baseball organization may be permitted to use the facilities and/or property during the baseball/softball season and a soccer organization may be permitted to use the facilities during the soccer season. B. All groups who use the concession will be responsible to maintain the concession stands to the standards established by the State of Florida Department of Health. Any Co-Sponsored Group that operates a concession, stand will be required to have their concession manager become a Certified Professional Food Manager. Concession cooking and sales are only permitted with a valid license from the Department of Health. With prior written approval from the Athletics {office, concession stands without a valid license from the Department of Health can only sell prepackaged foods that do not require preparation (chips, pretzels, etc.). Bringing foods to sell from home or grilling on site is not permitted. C. The City will retain the rights to program any facility and associated amenities (concession, press box, conference rooms, storage rooms, etc.) it deems appropriate at anytime during the year. All due diligence will betaken to minimize the impact on a Co- S pon sor Grou p, during th e i r season. The City of Clearwater reserves the right to open a n d staff the concession sta n d for a n y City sponsored event, regardless of the time of year of the event. The City will make every effort to work with the organization if the event is held during the organization's "tradition al"season, D. The City of Clearwater shall have the right to enter and remain upon its property for the purpose of examining and inspecting the space and determining whether the Co- Sponsor Group is in compliance with Department policies with respect to care and maintenance. Access to the concession stand and/or office building (pin numbers and/or keys) will be issued on an as needed basis through the City of Clearwater Parks & Recreation Department. The Co- Sponsor Group is prohibited from making copies of said issued keys. The organization may not change out any locks on any of the buildings. Anyrequest 15 1 Page EXHIBIT C.1 Criminal Background Investigation Policy For Adult Volunteer Coaches in Youth Sports The City of Clearwater„ Florida Dasa desi re to protect the safety a n d welfare of its youth during their participation in all sports or athletic activities that are Co-Sponsored by the City. Recognizing the nation-wide incidence of crimes against children requires pro- active steps to provide protection to children participating in organizations involving sports and athletic competition, The City requires that all coaches (must be at least 18 years or-older) that utilizethe City ath leticfacilities,or the facilities secured by the City,as a part of any City sponsored youth sports or athletic activities shall be required: to submit themselves to undergo a Level 11 or City approved equivalent criminal background investigation prior to their participation. One such example of a City approvedequivalent is a NCSI criminal background investigation. After initial compliance and everytwelve (12) months thereafter, all volunteer coaches as stated above must undergo a criminal background investigation. Criminal background investigations must be performed pr!qf to the volunteer being assigned any duties or responsibilities at any City sports or athletic facilities. The City may determine the time of year the investigations are to be conducted depending on the beginning of their practice season(s)or events. An individual convicted of any of the following criminal offenses shall be disqualified from participation as a volunteer in any City sponsored sports or athletic activities utilizing City sports or ath letic facilities. Aggravated kidnapping Indecent exposure Injury to elderly or Aggravated robbwy disabled. Aggravated sexual assault Intoxication offenses* Arson Kidnapping Assault* Mariju an a possession* Any violation of the law intended to control Murder the possession or distribution of any Obscen ity Prohibited sexuaI conduct controlled substance or Illegal dru_g Prostitution (including promotion of, Crimes against children aggravated pmmation of, solicitation) Deadly conduct Sexual abuse Delivery of marijuana Theft* DUI* I Vol u n tant hAnn L-Ini titer 17 1 P *NOTE: Assault/ D U I / Intoxication offenses/ Marijuana possession / Theft— Eligibility depends on the severity and length of time passed since the offense occurred. In misdemeanor convictions for these offenses, the disqualification! will occur with a second misdemeanor conviction, Depending on the time frame of the DUI, driving while representing the organization is not recommended. Th is I ist of offenses is not intended'to be all inclusive and in no way sets limits on the offenses that are deemed grounds for disqualifying an individual from affiliation with the Co-Sponsor Group. Decisions on all other crimes or offenses not otherwise described abo,ve,w,i]lbe,,made,,atthe sole,,,disc,;refion,of-the,Co-Spo,ns,or-Groupo,r- ,City,-'j,n,,accordance with the law. If a volunteer or other agent of the Co-Sponsor Group is determined eligible for affiliation and is laterarrestedl or convicted of any of the above crimes, he/she is required to notify the Co-Sponsor Group immediately, He/she will be removed immediately from his/her volunteer position until the case has been finally adjudicated. Failure to notify the Co- Sponsor Group of any arrests or convictions from the list above will result in the volunteer being immediately removed from all Co-Sponsor Group vol u nteer du ties for a minimum of twelve (12) months beginning on the date the failure to n otify was discovered, or for such othertime as required by law. In the event the Co-Sponsor Group is notified that a volunteer has been determined ineligible to volunteer for the organization, it is the responsibility of the organization to supply the Athletics Office with a revised volunteer list. INDEPENDENT SANCTIONING AUTHORITY COACHES,ASSISTANT COACHES, AND REFEREE BACKGROUND SCREENING The City requires that an "independent sanctioning authority", defined therein as, "a private, n o n-gove m me nta I en tity th at o rg a n izes,ope rates, o r coo rd i n ates a yo u th athletic team in this state if the team includes one or more minors and is not affiliated with a private school as defined in s. 1002.01" (Florida Statutes), conduct Level 11 (2) background screening pursuiantto s. 43 ,04, F.S., or City approved equivalent, of each current and prospective ath letic coach, Ath letic Coach is defined for these pu rposes as 1) "a coach!, assistant coach, or referee working for 20 or more hours within a calendar year, whether for compensation or as a volunteer, for a youth athletic team based in Florida; and 2) has direct contact with one ormore minors onthe youth athletic team." :Hns iespunsibility may not be delegated to an individnal Mam. 7he ffidePCSFIenl banctlionlFly duI may Not aulnorize any person to act as an athleticcoat h unlessa Level 11 (2) or City approved equivalent screening is conducted which does not result in disqualification as provided for in s. 435, F.S. Level 11 (2) or City approved equivalent background screenings must be conducted annually for each coach. The background screening shall include a search of the athletic coach's name, or other 18 1 P @ g (' identifying information against state and federal registries of sexual predators and sexual offenders, which are available to the public on Internet sites provided by the Florida Department of Law Enforcement unders. 943.043, F.S. and the Attorney General of the United' States under42 U.S.G. s. 1502► . An independent sanctioning authority shall disqualify any person from acting as an athletic coach as provided for in s. 435.04 or if he or she is identified on a registry as described above, must notify a disqualified person within seven (7) days of the background screening, advising of the results; and maintain for at least five (5) years, a copy of the results and written notice. 19 1 11 a g e EXHIBIT C.2. AFFIDAVIT OF CRIMINAL BACKGROUND SCREENING INDEPENDENT SANCTIONING AUTHORITY ("°I.S.A.") NAME: DATE: I® m sw ri yr affi rmi ni t Il in"di ri du� employed--by-, "or volunteering as a Coach, Assistant Coach, or Referee within my organization ('TS.A.'") providing services to City under this Agreement, or conducting activities on City property, have completed the background screening requirements set forth above and as required by law, and been deemed eligible by I.S.A. to provide services as a Coach„ Assistant Coach or Referee underthis Agreement. The information contained in this Affidavit is up to date as of the date this Affidavitis dated and furnished to the City of Clearwater Parks and Recreation Department per the requirements of Sections 14(f), 20, and 30 of this Agreement. All individuals providing services underthis Agreement are listed below. Each individual shall be identified by name, birth date and date deemed eligible. This affidavit must be provided to the City on the annual anniversary of the date above, for as long as this Agreement is effective. [Please attach additional sheet(s)if needed]. (List of Individuals) Name girth Date Date Deemed Eli ible 20MP bgF EXHIBIT C.3 ATTESTATION OF COACHES' CERTIFICATIONS By my signature, I attest that the coaches listed below have completed the following certifications/classes and are eligible to coach with the Organization. Name Certification Con taepresentative: Date:q)2M 2.0 22 !Page Signature of Affi ant Sworn to and subscribed before me th i day of 20 Notary Public My Commission Expires: Personally known OR Produced Identification Type of Identification Produced 1111 ;aF EXHIBIT E CO-SPONSOR GROUP'S RESPONSIBILITIES The Co -Sponsor Group agrees that during the term of this Agreement, the Co -Sponsor Group will at no cost or expense to the City, provide the following maintenance and/or repair. a. Stripe each turf field as needed. b. Pick up all paper, cigarette remnants and debris and place in trash -11,741t.:1," 1•111-1-..,11,1* 11 c. The Co -Sponsor Group will enforce the City's No Smoking Ordinance, No Pet's Ordinance, and all other posted rules. d. The Co-SponsorGroup, any league, team, group, or person, using a City park under this section and failing to leave it clean of litter to the satisfaction of the City, will reimburse the City for city worker time used to clean the facility. e. Provide for an y special needs or services such as security or traffic control devices or officers needed as a result of Co -Sponsor Grou p's use of the Facility. f. Light cleaning of the restroom facilities on a daily basis when in use. g. The Co -Sponsor Group shall not store any items outside the storage room nor dispense of any trash outside the facility area otherthan in containers provided by the City. h. The Co -Sponsor Group will issue to the City three keys to any Co -Sponsor Group initiated lock used at any City facility as well as anytime the locks are changed. i. As noted earlier, while the Co -Sponsor Group's use of the facility is nonexclusive, subleasing of the facility or assigning use of the facility by the Co - Sponsor Group is not permitted. Such activity by the Co -Sponsor Group could result in termination of th is agreement j. The press box, multi-purpose areas, office space, concession areas and storage rooms must be cleaned and organized on a nightly basis. The Co-SponsorGroup shall receive an invoice from the City, as applicable, if the Co - Sponsor Group does not follow through with these responsibilities. Failure to make such a payment vvill be grounds to bar the Co -Sponsor Group from use of the facility until Ihe fee is paid or acceptable remedial action is taken. Contact/Representative: Datetfr-qt 241Page EXHIBIT D PARKING RESTRICTIONS During the Co -Sponsor Groups season, the Co -Sponsor Group is responsible for assigning members of their organization to manage and control parking, and to keep fire Ian es an d access for emergen cy veh icles clear. The Co -Spon sorGrou ps will en sure that all vehicles onlypark in designated legal parking lots or stalls. Parking or driving on fields, medians, sidewalks, bike lanes, paths, or other unauthorized areas inside the park are strictly prohibited. The City ultimately retains the right to prohibit parking at any locator". The Co -Sponsor Groups will control the parking at the facilities they a. Countryside Sports Complex: Parking is not permitted along the right-of-way on McMullen Booth Road. Additionally, vehicles may not park in the swale between the sidewalk and the right-of-way. Co-SponsorGroups using th is ven ue will help promote good neighbor cooperation with Chi Chi's Golf Course by ensuring that Chi Chi's parking is not encroached upon. b. David Martin Fields at Glen Oaks Park: Parking is not permitted along South Hillcrest Ave., South Turner St, or South Evergreen Ave. c. ECM 8 and 9 Fields: Parking is not permitted in the EisenhowerSchool parking lot during school hours. d. Frank Tack Fields: Parking is not permitted in the grass along Montclair Road. e. Joe DiMaggio Baseball Fields: The Co -Sponsor Group will ensure that vehicle traffic associated with their activities will not drive on the maintenance/emergency access road between the turf multi-purpose fields. Additionally, no vehicles are permitted to park nextto the baseball fields. f. Sid Lickton Park Parking is not permitted along the roadside of Saturn Ave. g. Vehicles/trailers are not permitted inside any of the facilities nor on any turf surface without pdor written approval from the Athletics Office. h. Long Center No field parking u nless approved and responsible to reserve spaces for Long Center patrons as directed by staff. Failure of the Co -Sponsor Group to control the parking at any of these facilities during their activities will result in the Athletics Office reassigning the n umber of games, game start times, and/or the number of fields that can be in use at each facility to ensure compliance with the parking restrictions at each site. In addition, the City reserves the right to schedule staff at the Co -Sponsor Group's expense to assist with m !afing any parking concerns. Non-comptance mut tne assignea game sch eau le will resuit in the loss of pnvileges at that facility. Contact/Representative: Date: 9124 2c 231Page EXHIBIT F EMERGENCY ACTIN PLAN EMERGENCY ACTION PLAN for Facility Name: Facility Address:. Facility Phone Number: ©ate Prepared: 1 I EMERGENCY PERSGNEL NAMES AND NUMBERS Designated Emergency Contact Name: Phone: Back-up Emergency Contact: Name: Phone: EVACUATION 'ROUTES Site personnel should know at least two evacuation routes. Evacuation route plan. The following information is to be marked clearly on an evacuation plan that is readily accessible to the Emergency Contacts on-site. Emergency exits Primary and secondary evacuation routes - V ocations of fire extinguishers Fire alarm pull stations' location Assembly points EMERGENCY PHONE NUMBERS: 9-1-1 UTILITY COMPANY EMERGENCY PHONE NUMBERS Electric Company: Gas Company: 25i' P age EMERGENCY REPORTING AND EVACUATION PROCEDURES Types of emergen cie,s to be reported to site personnel are: • Medical, Severe Weather, Fire • Other, Terrorist attack, bomb threat, hostage, etc. MEDICAL EMERGENCY Call medical emergency phone number: 9-1-1 Provide the following information: • Nature of medical emergency, .. .. ............. Locationof­th-e:­i�, r ddtest',­bu]I'd ih­g`,­`r­d6`......in" n uim'bbif), Bund Your name and phone number from which you are calling. Do not move victim unless absolutely necessary, The following personnel are trained in CPR and First Aid to provide the required assistance prior to the arrival of the professional medical help: 1. 2. 1 Attempt first aid ONLY if trained and qualified, FIRE EMERGENCY When fire is discovered: • Activate the nearest fire alarm (if installed) • Notify the local' Fire Department by dialing g-1-1 • If a fire alarm is not available, dial 9-1-1 and notify everyone at the facility to evacuate to their closest exit. Fight the fire ONLY if- * The Fire Department has been notified, 0 The fire is small and is not spreading to other areas. * Escaping the area is possible by backing up to the nearest exit. 0 The fire extinguisher is in working condition and personnel aretrained to use it. Upon being notified about the fire emergencV, occul2ants must-, 0 Leave the building using the designated escape routes. 0 Assemble in the designated area (specify location): 6d P a g e Remain outside until the competent authority (Designated 'Official or designee) announces that it is safe to reenter. Designated Emergency Contact should: Coordinate an orderly evacuation of personnel. Perform an accurate head count of personnel reported to the designated area.. • Determine method......... to locate missing personnel. • Provide the Fire Department personnel with the necessary information about the incident. CHEMICAL SPILL. • Do not attempt to clean the 'spi..'...11 unles'stra.ined to do so. • Call 9-1-1 and attend to any injured persons. - (Evacuate buildi..ng as necessary. The following are the locations of: Spill Containment and Security Equipment Personal Protective Equipment(PPE): MSDS: When Chemical Spill has occun-ed.' • Secure the area and alert other site personnel. Call the Fire Department if site personnel are unavailable. SEVERE WEATHER AND NATURAL DISASTERS Hurricane: If Pinellas County is under a Hurricane "Match or Warning, all activities will be cancelled, and no one will be allowed to enter our facilities. Please instruct all parents, coaches, athl'etesto 'stay home and seek shelter.. LightninglThunde ( w .lightningsafety.noaa.gov) NoplaceOUT;SI E is safe during athunderstorml A house,orotherfu llyen closed building with wiring and plumbing offers your best protection against lightning. A car with a metal roof and sides is your second-best protection against lightning. • The "30-30 Rule' offers easy to follow lightning safety guidance. When you see under. if th at time is 30 seconds or ess, e uru erg orm is close enough to Be dangerous. Seek seer, If you can't see the lightning,yust hearing thethunderis a good back-up rile. Wait at least 30 minutes after the lightning flash before leaving shelter. Tomado.- a When a warning is issued by sirens or other means, seek inside shelter. 0 Con sider th e fol lowin g: Small interior rooms on the lowest floor and without windows, Hallways on the lowest floor away from doors and windows,and Rooms constructed with reinforced concrete, brick, or block with no windows, 0 Stay away from outside walls and windows, 0 Use arms to protect head and neck. 0 Remain sheltered until the tornado threat is announced to be over. ................. 2 8 f, a, g, e, EXHIBIT G CO-SPONSOR ORGANIZATION ANNUAL REPORT This documentation provides a breakdown of the organization. The document is an overview of the (year, season) City of Clearwater Co -Sponsorship Agreement This report is due Organization Description: (Brief description of organization's mission, history, and programs offered) Participation Numbers: (Number of participants per session and/or program, include participants info for each division/age bracket) Volunteer Numbers: (Number of volunteers and hours volunteered) Accomplishments/Highlights: (Awards, clinics, camps, championships) Requested Facility Improvements: (Add-ons or renovations which may benefit organization/other facility users) Contact/Representative: Date:CAZ dg EXHIBIT H Certificate of Insurance Sample SIMPLE CERTIFICATEOF LIABILITY INSURANCE IMS 6,CNWWAWK AM W qW,S kA Pi W4 MATUR CF mFYW)1WVAiVKA C,41,LW AND i J! C4ikt No RAW dNW°a,HWgr ME cum WKAH IWW,&GDER YMS S WCAVIW w4CWa VIII AJ.WVzCt IP401 aK;W bw'bAbP,MWGJ°I96`Wpk AN W&IC WWN 7A.,w WWW"- Wp0'�'„'9d fJIW r6 V.�19'W+ PIff uP0,4rt,IW@p1A prP1QJ,N�`% 'i IWH� 14Wb�?rf ur�,IC.-ti,W k k6WN4PO IMS WApC"ATtrlWAM Wt4r 4NWW{JGadWnAr E Wd"!MOB LMWCfl'T'f.AW'e a'4 '3m'C'IM04P i REWNP'wk'C'N OHtuW WbU4W'Waa IIdGV^WLAA'Wf k,,Aqq.AAPV'hf,,!VW`r1T1D, WtWAWV:4 C V{Wu4WIW CWL nm. kk ANO Pod,W,C�CA#Na W,Wlir mAWN�I4k ,nnW,kk,,, 6”' flANWh"'s��!✓GkdP LW 4Mr,�e�xwti wdMa�ug�4w&!w�;Clvtame un rrN..OIrvr¢mouama Z.ru,w�6"WrW"ifi.lmw W+k.AWMWI,t1WCC.krmWmwwAAi vmx rw Wm k+vzuuu�wrw x�� W*Mw"MA A 0 WW'lw", wmb..#mm 0.dwW_mW u,.mrvfmae8a'— rah 1h.F"A W, Falx A Mat—wo vo r Nig -14(u.Nk i w u uv AR ',W n W mw m w iW m N W twNw W A w&i mWw B k @a WM1 a P P y�.. �.....�... ...m .,...... .,,�,.mm ... .�,.. ....... ., x dl S URWCE 1DC4,51AVNY INK', 'M°TK4 r n u+'aWwWAA'4gw mAmw, Nil�u,•.�,�l�W »�tuW....,e. ,.� w�;'uf .i !WM�iy^fbA W ..............,. i �W "APre 6+CArP IF.� V IFI1W'CC6-luk�t'P Cv�,PE6W In!rE"�+I 7Wi�C�IIII:�" fA y„ fPA, ie,,rie,nu ,4 r WNC,IBJ If(.4 ff*61 m&p,Kt TL• W I.omfw trd,gra WMwy M1l f,'A raAl4F7 ri�.,!'�4 W H'F.W"M.D%W.@'�u'TW9lWri0k' aIN^PTME PIX MrV fERV M diN'M+1%P4 WYr f rroawuw W h,,;; m`rd,WWU «NA �WW,wd v^JCt9W"n,9p4a'r i;W J..-Frr 2i Wo {Irc tirvllhdz&°Y % nhMAD A MY KFkM. hoc NB fPAN' h AprCRZCEy *Er I ,E rdrk: }SE M1CR3r i%M „,W,.J.✓ 'WA Ad"C'"J.1�A'r"IwI.v0Awu:11!SQC'�, ow7' VA "h'VT,KE44 6'+'..Mu^,nO`"n W'IA41.1, . N W ,,.....�......... .....w_u._.. �m,' W E1. wnma 1 , krau.w" ra wuW ml� u ryry � rr�� ox,M EP rT'-p itgym, W wn^,Nl AGmL/ ,P WWm'wd!'N W 'A'w1'A i wYPNWAYudk.�; I rJb'° 4 i N a IiPflFF6 numuaWAe'k wA�u� w 7 rWlW,mew' CAil� f � f rk ilk e 1 7n"wWwWIN'+e w, FA !J,,.W.�.. .m...............�... �.. a _. r .� &auMM{94M1�9Jm iAoml(„ ! ! a r v*¢ 1 k�� r""t Wr^i it G W q m Wpd W,MmN4W'IMWN/wk ,krrlwx Y ,�„ wn*wWmmra��r�m^c 0 nNu u ry Aaomm�m+m� 2iPP �tSr�r C Ir1Cu4W t r PficP_ 'm mn,L,; T4 d ".� m,rWt;ter W fQI 54'.I m414db4W' '..&WwC W�d LLI; �R'w%CWAMeL 0.W W.AABX IRAY ifam ANN aWs�NekM Ilk I d4w9 d"v wuwdkpere�.rw Wnrc Mw. I a'F°N.dfiJ.,:xf'4;T^W CWC41H,A;.NlEAN)(N OAra:�'.SPa RE, TEAM f AAME O)f TEAM Asir'TEdAwpuCSq R I OTO SOF CLL EARMIATER 04D PINELLA L C04.r(#iN ARID&RE AD[Y7r(C,%4AL N J E`D i r L city of Clearwater _ "aHW4.roA-,CR.a"'�I AW�ti'C"rNW T#�A��AWw' �W,�W„"WCu"cCA 4'"W7W,W:J�4�Wr&"w�aWdMw�WIE411.IFF:k C k CBO:X 47Q Clearwater, m F.�.n i s ftt AAL aA10 2S( C W A4ll. The ACURib s mAWwr Ama l rA Wopn mu e rroo-'w'fam4 wm mute M A(L',w'! ....... ... ,....r ,,, .. .., , V �:.. ,...,.. ...., ......,., ._ ° EXHIBIT I ANNUAL FINANCIAL STATEMENT ANNUAL FINANCIAL STATEMENT FISCAL YEAR ENDING NAME OF OGANIZATION REVE Amount Item Registration CFYGrants Clinics Tournaments Sponsorships Concessions Fundraisers Donations Miscellaneous $0.00 Total Revenue $0.00 Tom Expenses $0.00 Total Revenue $0.00 Profit/Loss EXPENSES Amount Item Marketing Uniforms Awards Dues Opening Day Concessions Benefits Salaries Miscellaneous $0.00 Total Expenses Coma 'r - - ,— Date: 11116 311 Page EXHIBIT J - Clearwater Aquatic Team Special Conditions • The organization's president or authorized representative must attendthe co - sponsor president's meetings conducted by the Athletics Section. • Initial roster of all participants is due on October 1, 2020 • Rosters changes (additions, deletions) are due on the 15t Monday of every month for.-Nov--ember-2G20-.---,September 202-1-- ---- L. ---. _- -- - - -- 0 Cards must be valid for at least 50% of the month for all participants • Roster Payments for any kids without valid Long Center cards will be due by the 15th of each month • An accurate facility and!/or field schedule, depicting actual use i.e. games, practices, meets, tournaments, and events. Blanket schedules will not be accepted as firm schedules. The following dates apply.- * (Season)- Swim meet schedule MDue: 10115/2020 * (Season): School season training schedule a Due: 7/1/2021 * (Season). Out of school season training schedule 0 Due: 4/1/2021 A list of all coaches and their certifications and proof of required Level 11 or City approved equivalent background check is required prior to the start of every season for each team using city property. o Coaches Level 11 or City approved equivalent 0 Due: 11/15/2020 or prior to the first scheduled use o Coaches' certifications a Due: 11/15/2020 or prior to the first scheduled use • Co-Sponsored Usage Dates. o This agreement covers the requested' dates for competitive softball team practices only based on availability* a October 2020 - Septembe. --- I based on, pool availability • Additional Considerations: o CAT is not permitted to, instruct lessons level 4 and under o The city has the right to restrict or refuse programs or activities that are deemed to interfereor compete with the co-sp -s-o r program. ------------- —----------------------------------cy—T-fte-city Will ma storage space available to CAT. CAT may have to purchase specific containers for their equipment. o Any equipment, storage units purchased by CAT must have prior approval from city site supervisor. o Placement of equipment must be prior approved by site supervisor. Failure to comply will result in equipment taken into possession of Long Center Supervisor. o City staff will work alongside CAT staff, encouraging swimmers to progress/advance into the CAT organization. o CAT will have access to and use of the sundeck at no charge. These areas will be used to promote retail items for fundraising. The set up of least two weeks' notice. o The city will provide an invoice prior to the swim meet. All meet fees should be paid 7 days before the event with the exception of the "splash fees" which are due no later thL3 days after the completion of the meet. Dater kz:f t ze) Contact/Representative: V d),�ie"J"wam"r'A 0"I",q)u"�"t i"ard Apph" daov,MOO(7;710 CLEtkRWATER PARKS aft RECREATION DEPARTMENT RESIDENCY GUIDELINES L RESMENT& A Prtnide proof of residency- It ir up to the apphcanr to prove that he or she Ls a slm'ent reskiem of the City of Clearwater. Aar/two(2 1 ofdre following ad4rail docuntentz,will be suffinfent,Phwocapies are not acceptaW4. Plawf ofdependenry-Birth c*rt6cAre ar other pro-of of dependency maje foe requird, I A current State of Florkda photo AL-ntdcAtiou card or rurmn:veh4e regi:Tration, I Aci��n rioter idemnfication card Miowinft1re Cirj as 3, Any ortzm4 ut;Nty W1 ie:s than 9,0 dav,-old that shows apphrant z tivne and a City of Clearurater rtnidenrixi address as the senlice,adekvssw'Utility"inicludes ekectrir-te;ephonf,water,and/or table bidh,ty 4. A current yur,2tjiraL property ran bill 4or rvodv*,�taw your name shaMog a City of Clekmvati Froptrrf addrems, ........... ................... .. .................... .................................... ...................... ................ .................................................... ..................................._._..- P, ...... ................. An ogtMIIA, smart zized or registered deed,mortgage gj lease ilunoving yotT nanre a-d%,*avi or occupant at gnat C3tY of Cleanvater address. F. An a, Mm notaraed natearent ftom in afthreig"that pxj are,a fril tunt rvskient in bis or her hamte„mord any other two prioist Imed aboreshowing that hornvW a City of Cleawateraddrem FAMILY: Hu;hand and wife or two persans width a Reosterred Domevdc Partnemlup with the Ciry of Goamarer or Plusen&: CaunW"Florida,ora legal guardlan and their children who hv*in the sarne household,wbo,are 18,veaz-,of ap or under,air ler; than 23 VeArs of age and a fidl-tftne callele student Veiiftat.om of any ar,or fanuIV statues may be required, C. Complete and sip the Roavahan Card Applicadmi. D, Pay the appragnate registration fee,. Note 1: *Pe=Ane%,W CAa ofCleamraur employ"s.,their Immediate fungy ra,eunben,City of Ckanivatier redrelesand acthre lout? metsibers:of-the US.Coast GuArd or utilkary and their immedLare famnlies d,proof required)are exempt from the affi,er proof of rie,,Tidency reqigirements, Note 2: Falstfied Sant'ormaton-falsificAnon of appUcatin iriformatkm may disquahfy"die applwArot from future parricipaidon in City of Citarwater recreation progratris awl eo-spcnwr Vortt participabon. ZL RMIUM(Rec Urd/Flus Free) X Provideproof ef=rrentpensisin pay stub wfth medical insurance. 11L NON-RMENTS. I'migTams tbat typirafly reach capacity May have registration pmcedures that St"C*xrwater W'Aessm priality M 140NAESIDENT DIUBLID VETERANS-, Will need to provide documentation from the Veterans Admtai=ahon;which wiH be attached to the Rei.CAM Appboxbon, UV, ALL MUMMA=PLEASE NOM A. Piersomd trakdng is probibited at any*four(Adhtier,umlew the individual is a coattract inmucwr with the City of ClearwAtez B. Last CArds-A reptacement card for resident;and non-residewts cost S 5 plm tam C Refund Pofi6,es AU refund requestsarip rubjeot to admim5trxnan approval Mow four te-rix%*+k1,for refunds to be.processed. R*creebom Cards Re RoproatioN Cards voig nee ise ret"ed,ed**or""ba!ittes!d*72 ft"111 dste of ntine,Requeset fin reftuds In=be Sub.nixted ru WildrsT -.------- Open SwimfGpn,SkAte Refund It the dty must dirse a pool or skate park unexpectedly,participants,who have been At the(Acdity for less dian an hour,may be tven a rAin check for another itrit --------------------------------------- ............. 341 F, a EXHIBIT K Participant +hard', Application C'LEA.RhdiATE'at.PARKS&Pill:d;.RE"A"B`1'GAN DE'.k'^AR"EMENTr omm RECREATION CARD APPLICATION I1l'L9p MAr1r0.,.h7 d�Leofsa�rNerrau ffar«dz^a� : AU,9lEe;t IWA�it"tN,fR " ' lRi,' tl PALID P1107Y")WE 71076"A7"70S Pmrtaa A+Jastae List lRammse tut�.' lldslt d. _.,, „ S. 4. S, des:i� urr mres.A rrs;rr, Catwn Staatea Esga1 Madsrapa%ddressa CGtyr Slaw Cspt E•mmwar6 Addaez r Teleprbuarae 0; Con ak: Eanaergerrwt a Telephone KRt WAIVER Of RELEASE OF LIABILITY VTv�Irmftwh r'peni,�rwm,k'&/LsrprttIank",e,,a,.l ulCLwmfleewa au9nrovpzm,aG�w +fg,mw', Lr, CuentuktiaNrmr�pn0vro wrcrmR aq nww amuse ar, auwuga at ilt^Iw maudaw„rnlpauaG at ni,s�wtemk' arrw,mre.,�m�a„�wara+r Lena a a^d�rR�r wrata•w arnwwa�;dua:r¢ `daw aaamw e mix ru°aim ?,mw rPa�i,p+wt pea�C�rPHduaCaP_ Saztee tlae"Qtyv'rd'Ctaarwater is swat aware eB tmwe vat°nryr dtpendentr s p physical caft'drtt+asa atr tramrtlnE for vat6tam.t arttr6t6e5 and,im tvnsidas araetm of the laenrfits ant,a wgspoa~wezatantes affarded to My d*per+dotstltl or me by pac r&pattass rat,xrtirme5 tgmaariared by aha Cirp of Ciearvwracat,t state as Btwllzwwz: It l or my depwetrdesatil s B shomdd suffer an mntaury',ere 91nest as a parridpwatwt¢aut9rat°rre tw:mty rept^esentatrres sn use their dzarrebon to have alae or my depaesadetati;slk rrasmsperted,to'k medical rarmtrty for n*aromtetat acid l tW-full respr=ibRityP Ber tlrrls asrsew and agree to pay any tense Prsa"umed for this tre."Araent t urtlrrr agree to tmrdazzmz*ands etre and:farad 6aarardeas time Cn7 of Geartwaator,dts eamrplayree-s or Wza for anyw par nAl smpmnrtr taav depermderrt(a)or t.sara„ptrt mmrrut-r dosing pamrVati=tzar rtrreatte-az actavttma-z„ ?LEASE READ FACE OF FORM FOR IMPORTAXT IMPORTPARTICMANT INFORMATION R:P9ATION REFO IQNI GB Apph,camt's Signature or Legal Gmarv¢llass Cat-ApphCa rt Date OFFICE USE ONLY if Resident,proof of rrsrdetrrw a net^mllraettzsm tnarlsrded(nttmatltrsaamm of two)a esnwdent Cz Cnrrermt mortgage pe statement(90 days or loss)C3 Velaarle ve&tratauaaa Prrfpnetdy+Owner 0 P'lerada phow LD'Card Voter I.D.tndlratnnd'C "'" nrrs"dictdtmrt 0 Non-Resident Cd' +CtmrrentmatdttwbiU(i)lessthan SGdayrsawlda Type alabhtym Active pltttlw Military C Bdikaryr LM Silver Sneakers Cw Property Aptpraase,'s Office 0 Othen ::a City Employ" 0 City I.D. City IDO Doptft hair C Statin-Resident Dualml d Veteran l marnll aaeed tar provide dasrttamenta6rama from the Veter°asn'z Admimstr;atlrprml Cl Non-R.esWent Youth Sports Card(rerdy erttrrta program,are apwplRrabillr) p Totaul,Fres paid Method of Pawttnerrt lR,erempst tt ptw a rtemanon vershed bpr. (Ser t,da'N"ff'd„P trap'F71i,BNrp Nowh"'ULUKLE&crYAt'wp'a°aaaa,ew @Nkd'VNatk'3' a!dBdltrb,.P,ap&;t rd..awr, VPdr'4 71h,V w."MI>wb,BP Y9°OW,,R t'ANJ nJ'trr:r me Me,imh wv dinar ew,w"'awU'rj'#aw rmflf"A�o saw,:'ww ""AA wuuF,a,om,w, a„„wwCx"rod e" Lam6MP aaPO r/Lwr r,Aaemu'aa�;rmrvaWtwvcya.ee!"wvamawr mdA�rumrnr a"uwr pw yaw.rm^a.Lad+,avtrPhrNIPMnarmtu w aeue.*,u"r,rawew.e"Ith ajNra allA,1'rRuAk ow% ...........7............... ......_ ..,.,.,.,.....,. .,,,,,,,,