Camp Wyanokie Commission APPLICATION #_________
CALDWELL / FAIRFIELD / NORTH CALDWELL / ROSELAND / WEST CALDWELL
MUNICIPAL BUILDING, GOULD AVENUE, NORTH CALDWELL, NJ 07006
(973) 228-6432 – fax # (973) 228-2914
APPLICATION FOR USE
Individual/Organization Representative ___________________________________________
Organization(as appropriate) ____________________________________________________
Street Address ________________________________
Telephone (home) ______________________ (business)_________________________
Arrival __________ M ____________ 20___ Departure _________ M _____________ 20___
Leanto #1 ( ), #2 ( ), #3 ( ), #4 ( ), Troop 9 ( ), Yeoman’s ( ),
Lion’s Den* ( ), Campsite, NE ( ), South ( ), East ( ), West ( )
( ) Special Permission Request(s) _______________________________________________
* Please note that priority is given to groups of 20 or more for use of the Lion’s Den. If not in use, it is available to any permit holder.
Number of Persons: Youths _____________ Adults ____________
In connection with the filing of this application I hereby acknowledge that I have read the Rules and Regulations governing use of Camp Wyanokie, and agree to abide by them.
Additionally I, and all members of any group, agree to hold Camp Wyanokie harmless from any and all claims for damages which might arise from the exercise of privileges granted for the use of Camp Wyanokie.
Overnight Camping: $10.00 Registration fee per permit plus $5.00 per person – per night.
Day Usage: $10.00 Registration fee per permit plus $5.00 per person.
NON-RESIDENT INDIVIDUALS & ALL ORGANIZATIONS:
• Hold Harmless Agreement
• Certificate of Insurance
• Tour Permit
Your certificate of insurance must show a minimum limit of $500,000 per occurrence, bodily injury or/and property damage liability and should name Camp Wyanokie as an additional insured.
Application approved ( ) USE PERMIT – CAMP WYANOKIE COMMISSION
BY ________________________________ DATE __________
FEE RECEIVED ( ) AMOUNT ________________