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License Agreement Application Form

  1. License Agreement Application Form

  2. This form is for Shaker-based organizations to complete to request use of City and School parks and facilities for programs. Organizations are required to have a minimum of 50% Shaker residents on the roster for the clinic or league activity to receive permission to use fields and gyms. A license agreement is required on an annual basis to receive access to space. Failure to abide by the license agreement conditions may lead to refusal of space in the future. Please complete this form in its entirety to receive space. Failure to include the certificate of insurance will delay the agreement process.

    The license agreement is required to receive a permit to use park, open space, athletic fields and gyms. Use of space is dependent on the availability of requested space and compliance with license agreement terms and conditions.

  3. Association/Organization Information

  4. Please upload a list of officers' names, addresses, phone numbers, and email addresses. A Word document is preferred. 

  5. requested location(s)

  6. Please select your organization's preferred location(s).*
  7. If you selected "School District Indoor Facility" or "Other" in the previous question, please provide additional information here regarding your preferred location(s). If you have anything else to add regarding your preferred location(s), please do so here. 

  8. Please use this space to provide an outline of your organization's anticipated program schedule. Please list preferred day(s) and time(s) for organization activities, practices, and/or games. 

  9. additional information

  10. Association/Organization Insurance Certificates:*

    The association/organization completing this application must submit an insurance certificate naming the City of Shaker Heights as an additional insured with limits of at least one million dollars ($1,000,000) per person and three million dollars ($3,000,000) per occurrence.

    This information should be submitted to Erin Rose. Failure to submit the certificate of insurance will delay the agreement process.

  11. Field Maintenance Fees: *

    If applicable, field maintenance fees may be collected by the City of Shaker Heights. Fees are $25 for the first player, and $16.75 for subsequent siblings.

  12. Applicant Residency: *

    The primary contact for the association/organization completing this application must be a Shaker Heights School District resident.

  13. Participant Residency:*

    More than 50% of the membership of an association/organization and more than 50% of its participants must be Shaker Heights School District residents. 

  14. Participant Information:*

    A list of team members and full contact information for each (first name, last name, age, address, phone number, and email address) is required to be submitted one week prior to the first practice date. 

    This information should be submitted to Erin Rose

  15. Leave This Blank:

  16. This field is not part of the form submission.