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Application for Permit for Train Station Use (Print Only)
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APPLICATION FOR PERMIT FOR TRAIN STATION USE
Village of Riverside / 27 Riverside Road, Riverside, IL 60546 / 708-447-2700 / www.riverside.il.us
Rules & Regulations for Use of the Train Station
Please read before completing this form.
Organization making request
Briefly Describe the Event
Number of Anticipated Participants
Number of Riverside Residents Participating
Will there be an admission charge?
Date of Event
Start & End time of Event
Event will require use of (Please check all that apply)
Train Station Interior Waiting Room
Organization/Individual acceptance and agreement to adhere to Village of Riverside regulations.
I have received and read the regulations of the Village of Riverside as they pertain to the use of the train station and agree to those regulations.
It is understood that the total rental fee is: $___________________.
It is understood that a deposit of $______________ is required, returnable if no damages are incurred, and Train Station is left in the same condition as found and all rules and regulations are adhered to.
It is understood that the Organization/Individual is solely responsible for all damages to the Train Station, including any equipment or other personal property located within the Train Station.
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
Waiver and Release: As a condition of approval to use the Train Station, a permittee shall sign an indemnification and hold harmless agreement provided by the Village. In certain situations where the event or gathering activities warrant, the Village Manager may require as a condition of use, that the permittee provide proof of comprehensive general liability insurance, and dram shop or host liquor liability insurance (with the Village of Riverside, President and Board of Trustees, appointed and elected officials, employees, agents, volunteers, engineers and attorneys named as additional insureds) for the event or gathering in amounts and terms that are acceptable to the Village Manager.
To the fullest extent permitted by law, the undersigned hereby agrees to defend, indemnify and hold harmless the Village of Riverside, its officials, agents and employees, against injuries, deaths, loss, damages, claims, suits, liabilities, judgments, cost and expenses (including attorneys fees), which may in anywise accrue against the Village of Riverside, its officials, agents and employees, arising in whole or in part or in consequence of the undersigned's use of the Riverside Train Station or which may in anyway result therefore, except that arising out of the sole legal cause of the Village of Riverside, its officials, agents or employees. The undersigned shall, at its own expense, appear, defend and pay all charges of attorneys and all costs and other expense arising therefore or incurred in connections therewith, and, if any judgment shall be rendered against the Village of Riverside, its officials, agents and employees, in any such action, the undersigned shall, at its own expense satisfy and discharge the same.
The invalidity or unenforceability of any of the provisions hereof shall not affect the validity or enforceability of the remainder of this Agreement.
Agreed this ________ day of ______________________, 20______.
Name of Organization/Individual
Nothing set forth in this Agreement shall be deemed a waiver by the Village/City of any defenses or immunities relating to any person or entity or their property, that are or would be otherwise available to the Village/City or its Representatives under the provisions of the Illinois Local Government and Governmental Employees Tort Immunity Act, or that are otherwise available to local governments and their corporate authorities, officers, employees, agents and volunteers under the common law of the State of Illinois or the United States of America.
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