City of Lathrup Village

City of Lathrup Village

27400 Southfield Road

Lathrup Village, MI 48076 ALCOHOL PERMIT

(248)-557-2600

Name & Address Of Applicant:______

: ______

______

Customer Type: Resident Non-Resident Community Group

Event Type:______

Event Location: Community Room Meeting Place Municipal Park

Date (s) reserved ______

Note: This is an ALCOHOL PERMIT Not valid unless signed by the Lathrup Village Police Department.

I confirm that I/we will not sell/or provide alcoholic beverages and that there will be no alcoholic beverages served to any individuals

Under the age of 21 at our event.

I confirm that I we/ will leave the area in a clean and presentable condition.

Signed:______Date:______

Police Department Stamp:______

DISCLAIMERS

The Facility Rental Application & the Alcohol Permit must be carried with the permit holder at all times during the event. This permit only assures use of a specified area of the building/park identified on the application.

Said group agrees to pay City of Lathrup Village for damage to any property caused by said group at said location and said group agrees to pay the City of Lathrup Village a sum not to exceed $100 per area used if the area used by said group is not cleaned up and returned to the condition in which it was found.

ALCOHOL INFORMATION

Alcoholic beverages, including beer are prohibited in all public parks and buildings, EXCEPT BY PERMIT FROM THE CITY OF LATHRUP VILLAGE AND THE LATHRUP VILLAGE POLICE DEPARTMENT. Permits must be obtained at least one week in advance of the event from the Lathrup Village City office and then stamped by the Lathrup Village Police Department.

RELEASE AND HOLD HARMLESS AGREEMENT

Also, in consideration of being allowed by the City of Lathrup Village to possess and consume beer and /or wine at the above location and date(s), the undersigned, by this instrument does/do hereby expressly stipulate and agree to release, waive, discharge, indemnify and forever hold harmless the City of Lathrup Village, its departments, officials, officers, its assigns, agents, servants and employees and volunteers of and from all claims, demands, actions or causesof action now existing or which may hereafter exist by reason of any damage, loss, injury or death which heretofore has been or which may hereafter be sustained by the said INDIVIDUAL, GROUP, ORGANIZATION OR FAMILY in consequence of their participation in any and all activities in connection with issuance of this permit.

This release extends and applies to, and also covers and includes, all unknown, unforeseen, unanticipated and unsuspected injuries, death, damages, loss and liability and the consequence thereof, as well as those now disclosed and known to exist. The provisions of any state, federal, local and territorial law or statue providing in substance that releases shall not extend to claims, demands, injuries, death or damages which are unknown or unsuspected to exist at the time to the person executing such release, are hereby expressly waived.

APPLICANT HAS READ AND UNDERSTOOD THE ABOVE AND ITS CONDITIONS

ALCOHOL PERMIT (not valid unless stamped by the Lathrup Village Police Department)

I confirm that I /we will not sell alcoholic beverages and that there will be no alcoholic beverages served to any individuals under the age of 21 or who is visibly intoxicated at our event.

Signed:______Date:______

Police Clerk: ______

Contact Maralee Rosemond for further information.

248-557-2600 ext. 224