Smolak Farms Photography Permit

Smolak Farms, LLC
315 South Bradford Street
North Andover, MA 01845
978-682-6332 – Farm Stand
978-687-4029 – Education & Activities
www.smolakfarms.com
~ 2016 PHOTOGRAPHY PERMIT APPLICATION ~
PLEASE CHECK IN AT THE EDUCATION OFFICE UPON ARRIVAL AND A LANYARD IDENTIFICATION WILL BE ISSUED TO YOU.

RESPONSIBLE PERSON:___________________________________________

DATE: _____________
REPRESENTING (Company Name):____________________________________
ADDRESS:_____________________________TOWN:__________ZIP:_______

TELEPHONE: (_______)_______-__________ EMAIL:_______________________________________
REQUESTED AREAS:________________________________________________________
DATE: __________________TIME: Arrive___:___AM/PM Depart ___:___AM/PM
NUMBER OF PEOPLE: ____________ (farm is open 7:00 am to dusk)

FEE SCHEDULE: One time Permit (usually up to 3 hours) $50 Ten (10) Pack of Permits (valid for one year) $400 Seasonal Pass (Valid for One calendar Year) $600
Please reference fee schedule: TOTAL PERMIT FEE $_________ Please note: any additional cost for police, park staff, sanitary units, etc. will be borne by the applicant.
Smolak Farms cannot assume for itself any liability for injuries to persons or damage to their property while on farm owned land; persons entering thereon do so at their own risk.

I have read and agree that my group will comply with all Farm Rules and Regulations.

APPLICANT’S SIGNATURE_____________________________DATE _________

PAYMENTS: Checks made out to the Smolak Farms can be mailed with the application. Credit Cards can be accepted in person, over the phone or online.
$____________ Received in payment Receipt#______________ Date__________

APPROVAL □ DISAPPROVAL □ 2016