BOROUGH OF WHITEHALL APPLICATION FOR
USE OF PARKS AND RECREATION FACILITIES
 
TYPE your information. PRINT Form from browser. SEND Signed Form to Permits Office
 
Date Today: 
  PERMIT NO.____________
       
Facility Requested: 
  
       
Date(s) Requested: 
Times: 
 Days Requested: 
  Click:  Mon.: Tues.: Wed: Thus: Fri.:  Sat:  Sun: 
Date(s) Requested: 
  Time: 
 Days Requested:
 Click:  Mon.: Tues.: Wed: Thus: Fri.:  Sat:  Sun: 
 
Activity: 
       
Organization Name: 
Organ. Address: 
  ZIP: 
Organ. Phone: 
    
Person Responsible: 
Persons Address: 
  ZIP: 
Persons Phone: 
    
 
Number Involved: 
   Approx. Adults:  Approx. Children:  Whitehall Residents %: 
  
The presence or use or any alcoholic beverages on any borough recreation site or public street adjacent to any recreation site is PROHIBITED. Any group or organization, which sanctions the consumption of alcoholic beverages in violation of the above regulation, may not be granted a permit for the following season.
 
Signature: 
 _________________________________
Phone: 
       
Official Use:      
       
Granted: ________ Denied: ________ Date: __________ By: _______________________________
       
Comments: __________________________________________________________________
       
Comments: __________________________________________________________________
 
Keys for the restrooms must be picked up at the Code Enforcement Office the last business day prior to the date reserved and must be returned to the same location the following business day.
 
Mail or
Deliver To: 
 Borough of Whitehall Complex
c/o Park Permits
100 Borough Park Drive
Pittsburgh, PA 15236		  
Phone: 412-884-1368, Ext. 324