Get Watershed Recreation Permit Application 2014-2024

For internal use only Authorization Permit Date Badge United Water New Jersey 2014 SEASON April 1 November 30 Watershed Recreation Permit Application Please accept my application for a watershed recreation permit. I understand the badge is for my personal use only. 4 fully responsible for any damage to property belonging to the company or any third party resulting from or in Be connection with my participation in the watershed recreation program. I also assume all risks of loss and agree to completely release hold harmless and indemnify the company and its employees from any and all claims suits damages judgements or demands for property damage personal injury or death arising out of an accident or injury to myself or others resulting from or in connection with any use made of the company s property pursuant to this permit. 5 Minors must be accompanied by an adult badge holder. 6 Include a copy of a photo identification along with my application ex. I understand that I must 1 Abide by all state and federal fishing and game laws. Abide by all company rules and regulations to protect the water supply. These rules and regulations are included in the handbook you will receive with your permit badge. Display the badge at all times when I am on company property. I understand the badge is for my personal use only. 4 fully responsible for any damage to property belonging to the company or any third party resulting from or in Be connection with my participation in the watershed recreation program* I also assume all risks of loss and agree to completely release hold harmless and indemnify the company and its employees from any and all claims suits damages judgements or demands for property damage personal injury or death arising out of an accident or injury to myself or others resulting from or in connection with any use made of the company s property pursuant to this permit. 5 Minors must be accompanied by an adult badge holder. 6 Include a copy of a photo identification along with my application ex. driver s license. Applicant s name and address Type of permit Quantity Amount Total Adult 18-61 x 30 ea* Phone number Children 5 and under In case of emergency call Total amount enclosed FREE Additional applicants family members only Please list Names of all applicants Seniors Juniors and Children- also list ages Will you be needing wheelchair access Yes No Applicant s Signature Please include a copy of a photo ID Signature of Parent/Guardian if under 18 Car 1 make / model Car 1 license plate Make checks payable to Send application along with a copy of a photo ID and payment to STARNET Starnet - NJ / NY P. I understand that I must 1 Abide by all state and federal fishing and game laws. Abide by all company rules and regulations to protect the water supply. These rules and regulations are included in the handbook you will receive with your permit badge. Display the badge at all times when I am on company property. These rules and regulations are included in the handbook you will receive with your permit badge. Display the badge at all times when I am on company property. I understand the badge is for my personal use only. 4 fully responsible for any damage to property belonging to the company or any third party resulting from or in Be connection with my participation in the watershed recreation program* I also assume all risks of loss and agree to completely release hold harmless and indemnify the company and its employees from any and all claims suits damages judgements or demands for property damage personal injury or death arising out of an accident or injury to myself or others resulting from or in connection with any use made of the company s property pursuant to this permit. .