2014 Park Facility Use Agreement

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* Required information.
Park Requesting *
Date Form Submitted *
Start Date *
End Date * 1000
Start Time (include set-up) *
End Time *
Type of Activity *
Organization/Group *
Contact Person Name *
Email *
Address *
Phone *
Alternate Phone *

Note: Playgrounds & Frisbee golf course CANNOT be reserved—open to public at all times.

Exclusively Reserved *
Field Reserved *

There is a $35.00 fee for field reservations at NCP and an additional $20.00 with lights for each field requested.


In consideration of the receipt of this permit from the City of Rogers, the Permittee hereby releases the City of Rogers from all injury and any liability of any kind arising from the Permittee’s use and occupancy of City property and agrees to indemnify and HOLD HARMLESS the City of Rogers, its agents, or servants.

In no event shall the City of Rogers be liable for any damage or injury to Permittee or any agent or employee or to any person coming upon the premises in connection with the Permittee’s use and occupancy of the premises.

Permittee acknowledges that it shall reimburse the City of Rogers for any and all damage to property of the City of Rogers, its agents, and/or its servants, as a result of the use and occupancy of the premises (ordinary wear and tear excepted) by Permittee, its agents or servants or by any person coming upon the premises during the Permittee’s use as an invitee or licensee of the Permittee.

Permittee agrees that the rights and obligations under the permit and this agreement shall insure to and be binding on its successors and assigns.

This HOLD HARMLESS agreement MUST be signed by Permittee and received and signed by the City of Rogers before any permit will be issued.

  • I have fully informed myself of the contents of this agreement before signing it and I do hereby agree to the following stipulations regarding use of the park, equipment, shelters, etc.
  • Keys for park shelter or bathrooms will be picked up & returned upon final clean-up/lock-up to the Rogers Activity Center. (If applicable)
Agreement *
I have read and agree with the above statements


Park Shelter/Gazebo rental fee for residents *
Less than 50 people = $40
50-100 people = $60
More than 100 people = $120
I am not a resident and will fill out the next section
Non-resident Fees *
Less than 50 people = $50
50-100 people = $80
More than 100 people = $150
I am a resident
Special Events *
Permit Fee (Flat Fee) = $60
Event within City Park only (i.e. concert) = $250 min./escrow
Event using City trails, sidewalks, streets, etc. (charity walk) = $750 min/escrow
I am not holding a special event

Please add up your total fees and enter the amount here. Mail your check to City Hall: 22350 South Diamond Lake Road, Rogers MN 55374

Total Fees *
Agree to Pay *
I agree to pay all fees related to park and field usage

Rogers Parks

Triangle Park - 21400 Rouillard Ave.
shelter picnic area w/ electricity, small ball field, playground, restrooms

North Community Park  - 13750 Bittersweet Lane
soccer, ftball & ball fields w/lights, gazebo, playground, building restrooms

Henry Woods - 12720 Brockton Lane (Cty Rd 13)
nature trails, More to be developed

Hassan Meadows  - Bechtold Road off of 109th Ave. N (Cty Rd 117)
hiking/biking trails,  ½ ct basketball, sand volleyball ct,  small ball field,  picnic pavilion, Frisbee golf