Stationary Float/Light Display Application
EVENT TIME: Saturday, December 12, 2020, 5-8pm
Displays set by 4:30pm * Drive Thru start: 5:00pm
Contact us at recreation@lagrangeny.gov or (845) 452-1972 with any questions.

DEADLINE FOR APPLICATIONS: December 8, 2020, 11:59pm
Email address *
Organization/Individual Name *
Organization Website/Social Media Page
Organization Address *
Lead Contact Name *
Lead Contact Email *
Lead Contact Phone Number *
How would you like to participate? *
Required
Type of Display *
Required
Design Theme
If donating supplies, what will you be donating? Please have to Recreation office at Town Hall by 12/8.
Number of Display attendants (limit 10). You MUST be able to social distance within your group.
I have read and understand the Event Guidelines set in place for the Festival of Lights Drive-Thru Edition.
Captionless Image
PERMISSION/AGREE TO HOLD HARMLESS
As the participant signed below, knowing fully that the Town of LaGrange Parks and Recreation Department provides the program activity, and or special event and all aspects associated with these being; Facility(s), Instructor(s), Equipment and Supervision, I hereby: 1. Agree to furnish my own insurance in case of injury, 2. Assume all risks and responsibilities of possible injury invovled with participating in this program, 3. Testify that I am in sound health and capable of participating in the registered program, 4. Further agree to indemnify and hold harmless the Town of LaGrange, Parks and Recreation Department or employees, to include volunteers, from liability resulting from my participation in this program, activity or special event.
Signature of Individual. Please type full name and click "Accept" in following question if you have read the Permission/Agree To Hold Harmless statement above. *
By clicking "Accept" below, I confirm my intent to sign this agreement electronically. *
Required
I understand this application does not ensure entry. I understand this application will be reviewed and approved or not approved by Director. *
Required
A copy of your responses will be emailed to the address you provided.
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