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KDWPT Special Event Permit & Facility Reservation Application

Use this form to request and make campsite/event reservations at Kansas State Parks.

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 Daisy
 Brownie
 Junior
 Cadette
 Senior
 Ambassador
 
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Please put in the following format: MM/dd/yy
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Please put in the following format: MM/dd/yy
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You must meet the girl-adult ratio as listed on page 45 of the Volunteer Essentials manual
 
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You can offset the cost of parking permits by completing a service project approved by a State Park Ranger. Volunteers with current State Park passes do not need a parking permit.
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 Food, merchandise or services will not be offered for sale; entrance fees will not be collected; tickets will not be sold; sound amplification systems will not be used; cereal malt beverages will not be served; firearms or fireworks will not be discharged; and fish or wildlife will not be tagged or marked.

By providing an electronic signature, you agree with the following:

As an authorized representative of the organization listed above, I do hold blameless, protect and indemnify the Kansas Department of Wildlife, Parks and Tourism for damage or loss of property and injury or loss of life resulting from this event. I certify that the event described above and on all attachments will be executed in accordance with conditions specified herein and in statutes and regulations of the State of Kansas. I accept full responsibility for any damage to the facilities, grounds and natural features of the event area, including litter, vandalism and reckless damage resulting from the event. I further certify that all the above information is true and correct, to the best of my knowledge, and that I have read the Special Events General Regulations Summary.

Troop/Service Unit contact name

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This serves as an electronic signature of an authorized organization representative.
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Please put in the following format 5555555555

Troop/Service Unit contact address - No. 2

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Please put in the following format 5555555555
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Girl Scouts of Kansas Heartland will email confirmation to this email address.