Application for Pavilion Rental Instructions
1) Contact the West Goshen Township Park and Recreation Office (610-696-5266) to check pavilion
2) Read the Attached Application for Pavilion Rental, Release and Indemnification Form, and West
Goshen Township Parks Rules and Regulations.
3) Complete the Application for Pavilion Rental and the Release and Indemnification Form.
4) A Certificate of Insurance is required from corporations covered by liability insurance. Contact your
insurance company for a copy of this certificate.
5) Return the Application for Pavilion Rental, Release and Indemnification Form, along with Certificate
of Insurance (if applicable) and appropriate payment at least ten days prior to your picnic to:
Park and Recreation Office
West Goshen Township
1025 Paoli Pike
West Chester, PA 19380
PATRICIA B. MCILVAINE, Chairman
EDWARD G. MEAKIM, JR., Vice Chairman
DR. ROBERT S. WHITE, Member
CASEY LALONDE, Township Manager
Board of Supervisors
1025 Paoli Pike n West Chester, PA 19380-4699
610696 5266 ~ Fax: 6104290616
Application for Pavilion Rental
West Goshen Community Park ______
DATE OF EVENT
(10 days advance notice required)
(End time no later than sunset)
I (WE), THE SPONSOR, assume full responsibility for any damages to Township equipment and property. Further
more, I (we) understand that the Township will not be held liable for any injury or damage which may occur to me, my guests,
and our property during our use of the park. I (we) acknowledge that I (we) have read and understood the park regulations.
Sponsor’s name Street address
/Township in which res