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Parks Recreation & Community Services

Facility Rental Refund Form

Damage Deposit Refund

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Rental Information

Date *

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edit-submitted-rental-information-date-year

Rental Facility *

Facility Condition Report

Were the chairs & tables put away?

Yes

No

N/A

Were chairs & tables clean?

Yes

No

N/A

Is the White Board there?

Yes

No

N/A

Is the Picture Hanging System there?

Yes

No

N/A

Was trash and recycling emptied?

Yes

No

Was there any damage to the facility?

Yes

No

Were the facility keys lost?

Yes

No

Were the keys returned to the City by the return date?

Yes

No

Did City staff have to clean or conduct repairs to the facility?

Yes

No

Clean/Repair Comments

List cleaning done or repairs made by City staff.

Did the City have to purchase any materials or hire services to conduct a repair?

Yes

No

Facility Assessed By: *

Damage Deposit Refund

Damage Deposit Amount on File

Numbers only

Refund Amount

Numbers only

Total Damage Deposit Refunded

Yes

No

Reason for Deduction

Rental Organization/Person *

Brenda Burke

Bre Ganne

Chan Hettle

Parks Recreation & Community Services Home
City Parks
City Trails
Parks Volunteer Opportunities
Parks, Rec, Trees and Trails Advisory Board
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FAQs

Contact Information

Michael Todd
Parks & Facilities Manager
(360) 379-5081
mtodd@cityofpt.us

Parks, Recreation Department General Phone:
(360) 344-3064

Address:

Mountain View Commons (next to the Police Station)
1925 Blaine Street
Port Townsend, WA 98368

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250 Madison Street Port Townsend WA 98368 Phone (360) 385-3000

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