You can fill out the application and return to the park via email or fax.

Dear Picnic Patrons: FRANKLIN D. ROOSEVELT STATE PARK 2957 CROMPOND ROAD YORKTOWN HEIGHTS, NY 10598 TEL: (914) 245-4434 FAX: (914) 245-7958 FDRSP@parks.ny.gov Thank you for considering F.D.R. State Park for your picnic event. Enclosed you will find this year s picnic permit application as well as park use information. Our website and park office also have information about each of our picnic areas. We recommend you read through that before selecting a picnic area for your event. Please be sure to read all of the information carefully in order to make your visit to F.D.R. even more enjoyable. You can fill out the application and return to the park via email or fax. Please refer to the updated Picnic Map as some things have changed. Be sure to keep in mind: The fishing pier at the boat rental area is available for use. A valid NYS fishing license is required for persons age 16 and over. Licenses and bait are not sold at the park. Groups with buses are not permitted in Lots 1 and 6. No exceptions will be made. The pavilion in Lot #4, 4BS, requires a minimum reservation of 100 people. Smoking is not permitted in the playground, inside shelters, and inside pool areas. Please contact the Park Office if you require a wheelchair-accessible picnic site. We do not have wheelchairs. Reservations can be made over the phone. For quickest service, you must fax or mail both pages of the application, then call with credit card payment information. Cash is accepted in person only. We accept checks or money orders through the mail or in person. We cannot make reservations without payment and a completed application. Your application will not be processed unless we receive both pages, with the second page signed by a group representative who will be present at the picnic. If you are a tax exempt organization and plan on entering the park by bus, please enclose a copy of your Tax-Exempt Form ST-119.1 with your application. This gives you a $40 discount on each bus entrance fee of $75. A bus is any vehicle (including vans) with greater than 15 person capacity, regardless of occupancy. Motorcycles pay the same fee as cars. For buses, please bring the appropriate entrance fee when visiting the park; we accept cash, check, money order, or credit card payment in the Office. Bus groups must sign in at the Park Office upon arrival. Toll booths and boat rentals are cash only. Exact amount is highly recommended. We now accept credit cards for pool admission. The Park Office accepts credit cards for vehicle admission - please use the Route 202 entrance to access the park for credit card purchase. Reservations are not guaranteed unless a group representative signs in at the park office by 11:00AM. Unused tables/grills are available at the discretion of the Park Manager for use by other patrons after 12:00 PM. If your arrival is going to be delayed, please call the Office at the above number to retain your reservation. There are no picnic reservations or buses allowed on July 4, 2016. Our facility has green dumpsters and garbage bag dispensers located throughout the park to assist you in garbage removal. You are expected to clean your picnic area prior to leaving; failure to do so will result in a charge for cleanup and/or future denial of reservation application. Open parties are not permitted you may not advertise to the general public about your event Please do not make any plans until you have received a confirmation of your picnic back from us. If you have any questions about making a reservation, or would like to check on an existing reservation, please do not hesitate to call us at (914) 245-4434. Sincerely - Franklin D. Roosevelt State Park

2016 PARK USE INFORMATION PLEASE HELP TO KEEP OUR PARK CLEAN BY PLACING YOUR TRASH IN THE GREEN CONTAINERS LOCATED THROUGHOUT THE PARK. PLASTIC BAGS ARE AVAILABLE IN EACH PICNIC AREA, BUT YOU ARE ADVISED TO BRING A SUPPLY OF YOUR OWN PLASTIC BAGS AS WELL. WE APPRECIATE YOUR COOPERATION. PARK HOURS: 8 AM to sunset. VEHICLE ENTRY: ALL VEHICLES ENTERING THE PARK MUST PAY THE APPROPRIATE FEE. Fees are collected weekends & holidays May 21 June 12 & September 10 October 16. Fees are collected DAILY June 13 September 5. Buses: With a tax-exempt form, entrance fee is $35 per bus. The tax-exempt form must be shown to a park representative on the day of the picnic or sent with picnic application. Buses without a tax-exempt form or tax-exempt status must pay $75 per bus. A bus is a vehicle which can carry more than 15 passengers. Buses are NOT ALLOWED in the park on July 4. Buses must have advance reservations from June 11 September 5. Weekday reservations are not required for groups of less than 25 people. Bus groups are not allowed in areas 1 or 6. BUSES ARE NOT ALLOWED ON THE TACONIC STATE PARKWAY (see separate bus directions). Vehicles: Car, van, & motorcycle entrance fee is $8 per vehicle. **Exact amount recommended.** Empire Passes are available for a cost of $65 and allow car fees to be waived. They are valid from date of purchase to 3/31/17 and can be purchased at the Park Office or from the NYS website at nysparks.com/admission/empire-pass. SWIMMING POOL: Opens DAILY June 18 September 5, weather permitting. Hours: Weekends & holidays 11 AM 6:30 PM (last admission at 6 PM) and weekdays 11 AM 5:30 PM (last admission at 5 PM). Free Learn to Swim sessions are held weekends from 11 AM 1 PM. Please see lifeguards. Fees: Under 10 years of age: $1.00; 10 years old and older: $2.00 **Exact amount recommended; credit cards accepted.** Bring your own lock or purchase one from our Pool Office to use our lockers. We are not responsible for lost or stolen property. Children age 10 and under MUST be accompanied and supervised by an adult (age 18+) AT ALL TIMES. Food or drinks of any kind, in any container, coolers, radios, and swimming aids are NOT ALLOWED in the pool area. NO STREET CLOTHES ALLOWED IN POOL AREA. (See pool rules for more detailed information.) Children not toilet trained or persons who are incontinent must wear swim diapers in the pool. Children s swim diapers are sold at the Pool Office. Smoking is not permitted inside the Pool Area. ROW/PEDAL BOAT RENTAL: Open weekends & holidays June 18 September 5, weather permitting. *CASH ONLY!* Hours: 10 AM 7 PM (last rental at 6 PM) Fees: Rowboats $30 deposit; $7 per hour or fraction thereof (1 3 hours); daily rental $28 (more than 3 hours) Pedal boats $30 deposit; $5 per half hour (2 hour maximum) The renter must be 18 years old and must present proof of age. Maximum of 4 persons in a boat (including children); some boats only hold 3 persons. Young children must be capable of sitting up by themselves and may not be held in an adult s lap. NO SWIMMING in the lake. No standing, splashing, or horseplay. All boat occupants must wear life vests properly at all times. Permit will be revoked without refund of deposit if rules are not followed. Pets are not permitted in the boats. PICNIC RESERVATIONS: Picnic reservations are required for groups of 25 or more. The fee is $30 per 50 people. Shelters require extra flat fees of $25 for 3BS, $100 for 4BS (minimum reservation 100 people), and $50 for 6CS. VEHICLE ENTRY FEE IS NOT INCLUDED. No reservations or bus groups on July 4. Your reservation will NOT be confirmed without a signed application and payment in full. DO NOT make plans until you have received written confirmation from us. Make check or money order payable to FDR STATE PARK, or call Park Office at 914-245-4434 x8 to pay by credit/debit card. ALL VEHICLES (cars, motorcycles, and buses) must pay the entry fee upon arrival to the park ON THE DAY OF YOUR PICNIC. If your group is arriving by bus, please follow the instructions for buses under Vehicle Entry above. Picnic tables are distributed depending on the number of people for whom the area is reserved. Barbecue grills are available in the picnic areas (no gas grills allowed). Please be sure to extinguish your hot coals after barbecuing as they can become dangerous. You must sign in by 11 AM to ensure your reservation. Please call the Park Office if you are running late. If ALCOHOLIC BEVERAGES (wine and/or beer ONLY) will be consumed at your picnic, please fill out a free alcoholic beverage permit at the Park Office when you come to sign in. The permit holder and the alcohol users must be at least 21 years old. Smoking is not permitted inside the picnic shelters. Please dispose of all cigarette butts responsibly. RECREATION PROGRAMS: Athletic equipment is available on loan at the Park Office. A deposit is required.. PLAYGROUNDS: Our Playground is located in parking lot #2. Smoking is not permitted in the playground area. HIKING TRAILS: FDR State Park has clearly marked hiking trails. A trail map is available at the Park Office. PETS: Pets are not allowed in the picnic areas or playing fields and MUST be leashed (6-foot leash) at all times. Pet owners are responsible for cleaning up after their pet(s). Please use the pet stations provided along the park roads. Do not leave pets unattended in vehicles. OTHER EQUIPMENT: Drones, remote-controlled toys (cars, boats, planes), kites, scooters, skateboards, and inline skates are NOT PERMITTED in the park. Bicycle riders under 14 years old must wear properly fitting helmets.

F.D.R. STATE PARK 2957 CROMPOND ROAD YORKTOWN HEIGHTS, NY 10598 TEL: (914) 245-4434 FAX: (914) 245-7958 FDRSP@parks.ny.gov 2016 PICNIC PERMIT APPLICATION (Please Print Clearly Illegible Forms Will Be Returned to Applicant. Application can be emailed to FDRSP@parks.ny.gov.) 1 (office use only) PERMIT #: PICNIC DATE: PICNIC AREA: ALC. PERMIT: Y N PAID$: CHECK#: PARK REP: READ BOTH SIDES OF THIS APPLICATION CAREFULLY & SIGN ON BACK NAME OF ORGANIZATION/EVENT CONTACT/RESPONSIBLE PERSON MAILING ADDRESS APT. CITY STATE ZIP TELEPHONE (DAY) (CELL) FAX EMAIL ADDRESS May we provide your contact information to the organization Friends of FDR State Park? Yes 1 ST CHOICE: REQUESTED DATE REQUESTED AREA 2 ND CHOICE: REQUESTED DATE REQUESTED AREA Groups larger than 150 people will not be permitted in Lot #1 mid-june through Labor Day IF YOUR CHOICE IS NOT AVAILABLE, MAY WE SUBSTITUTE OTHER AREAS? ( Y N) # OF PERSONS (Please be accurate; this number determines your quantity of tables and grills. If numbers are larger than originally stated, you must report to the office to update payment.) PICNIC RESERVATION INFORMATION FEES: For reserving a picnic area only; does not include vehicle entry. Make checks or money orders payable to FDR State Park and send a self-addressed stamped envelope for reservation confirmation. We accept credit card payment over the phone after receipt of signed picnic application via mail or fax. Please call the Park Office to make payment arrangements. You will receive written confirmation by mail. Reservations are processed in the order in which payment is received. 1-50 persons = $30 51-100 persons = $60 101-150 persons = $90 151-200 persons = $120 201-250 persons = $150 251-300 persons = $180 301-350 persons = $210 351-400 persons = $240 401-450 persons = $270 451-500 persons = $300 Maximum = 500 persons NOTE: THERE IS AN ADDITIONAL FEE FOR PICNIC SHELTER RESERVATIONS (Area 3BS requires an additional $25 shelter fee) (Area 4BS requires an additional $100 shelter fee; minimum group size is 100 people) (Area 6CS requires an additional $50 shelter fee) PAYMENT AMOUNT (FULL PAYMENT REQUIRED) $ ** Please note that there is a $20.00 returned check fee. ** VEHICLE FEES ARE PAID WHEN ENTERING THE PARK. DO NOT SEND PAYMENT FOR BUSES! ARE YOU A TAX EXEMPT ORGANIZATION?( Y N) IF YES, PLEASE ENCLOSE COPY OF FORM ST-119.1 VEHICLES (Vehicle fees are paid when you enter the park.) #BUSES #CARS This permit is valid only for the original date booked and does not imply a rain date. THIS PERMIT DOES NOT BECOME EFFECTIVE UNTIL APPROVED BY A PARK REPRESENTATIVE. DO NOT MAKE PLANS UNTIL YOU RECEIVE A COPY OF THIS PERMIT AS CONFIRMATION. **PERMIT CONTINUES ON REVERSE AND IS NOT VALID UNLESS SIGNED** No

*REFUND POLICY* Picnic cancellations may be made at any time. However, if you are requesting a full refund, a refund request must be RECEIVED a minimum of thirty (30) days prior to the date of your reservation. A 50% refund will be given to requests received up to ten (10) days prior to reservation. No refunds will be given to requests received less than ten days prior to reservation. Refund requests must be made according to OPRHP policy, which requires a letter stating the reason for your refund sent to the Park Manager. Bad weather is NOT a valid reason for a refund. Please include your original receipt and application with your letter. Please note: a $9.00 processing fee will be deducted from your refund amount. *LIMITATIONS* NO RESERVATIONS & NO BUSES ON JULY 4 TH! ALL FIRST COME, FIRST SERVED. ALL BUS GROUPS arriving from JUNE 4 th to SEPTEMBER 5 th MUST HAVE RESERVATIONS. **No buses or bus groups are allowed in parking lots #1 or #6** You must give an accurate estimate of group size; otherwise, you may find yourself in an area too small to accommodate your group. Picnic permits are valid only for the original date booked. If you desire a RAIN DATE, you must make a separate reservation and pay a separate fee. You may request to reschedule your date in advance; requests will be granted based on availability of picnic areas. *PERMIT CONDITIONS* 1) In order help us keep the park useable for picnicking, you are required to dispose of your trash in the provided green dumpsters located throughout the park. Garbage bags are available to assist you in your trash clean up. Please bring a supply of your own garbage bags as well. If your area is not cleaned after you use it, you will be billed for clean-up costs. 2) Vehicle use fees and/or any other park fees must be paid upon entry to the park facility and are subject to change. 3) This permit is subject to the rules and regulations of the Office of Parks, Recreation, and Historic Preservation (OPRHP), Taconic Region, which can be found at http://nysparks.com/publications/documents/nysparksrulesregulations.pdf, and all special conditions enumerated in the permit. Please bring this permit with you; it must be shown to any agency official upon request. 4) Smoking is not permitted at the park playgrounds, inside picnic shelters, or inside the pool area. 5) OPRHP will not be responsible for providing any utility or service in excess of that which is already available. 6) It is understood that no alterations are to be made at the picnic site (e.g., cutting trees or branches, or erection of signs, banners, flags, tents, hammocks, etc.) without the express written authorization of the Park Manager. The permittee will be responsible for any damages to park property or facilities resulting from the group s activities under the permit. 7) The responsible party must be present for the entire duration of the permit and must present proper identification upon request. 8) Alcoholic beverages (beer or wine only, no hard liquor) are allowed by permit only. A free alcohol permit can be obtained at the Park Office. The sale of food or other items is prohibited. Open parties (advertised to the general public) are not permitted. 9) Use of Amplified Sound Equipment, Generators, or 12 Volt Batteries to Power Equipment is Strictly Prohibited. Battery-powered megaphones may be used to address large groups. Battery-powered radios are allowed. Picnic areas and pavilions do NOT have electrical outlets except in the restrooms; extension cords are not permitted. 10) Vehicles are not permitted to drive or park on the grass, service roads, pathways, or along roadways. Observe speed limits. 11) Scooters, skateboards, and rollerblades are NOT permitted in the park. Bicycle riders under age 14 must wear proper helmets. 12) Pets are only permitted on park roads & trails & must be on a 6 leash at all times Pets are not permitted in picnic areas. 13) Kites, drones, and/or remote-controlled toys (cars, boats, planes, etc.) are NOT permitted in the park unless authorized in writing by the Park Manager. 14) Grilling is only permitted in the picnic areas. Please use the charcoal grills provided; gas or propane grills are not permitted. 15) Hot coals must be extinguished after barbecuing. Ash from personal grills must be placed in a park grill, not on ground. 16) All accidents, injuries, or other problems must be reported to the Park Office immediately: 914-245-4434 x8 17) The permittee agrees to indemnify, defend, and save harmless the People of the State of New York from all suits arising from the operation of this permit or as a result of the consequences of any act, omission, neglect, or misconduct on the part of anyone associated with the permittee on this project. 18) It is understood that this permit is not transferable and may be revoked at any time at the discretion of park representatives. 19) A group representative must sign in at the Park Office by 11:00 AM in order to guarantee your reservation. 20) F.D.R. State Park reserves the right to open to the public any picnic area not checked in by 12:00 PM. 21) Any unused tables and grills may become First Come, First Served for other park visitors to use AFTER 12:00 PM. 22) All information contained in this permit may be shared with other New York State agencies. I HAVE READ AND AGREE TO THE TERMS ON THIS PICNIC RESERVATION APPLICATION. I hereby apply for a picnic permit for the group I represent. I have read all the terms and conditions contained on both sides of this application and agree to follow them. I understand this permit may be revoked if any of its terms or conditions are violated. SIGNATURE OF PERMIT HOLDER: DATE: 2

Franklin D. Roosevelt State Park 2957 Crompond Rd Yorktown Heights, N.Y. 10598 (914) 245-4434 Pool is open daily from June 18 through September 5, 2016, weather permitting Please check the weather forecast before committing to your visit Pool hours of operation: Weekends & Holidays: 11am -6:30pm, last admission 6pm Weekdays: 11am -5:30pm, last admission 5pm 2016 POOL RULES Safety instructions of lifeguards and/or Park personnel must be obeyed immediately. Patrons who bring bags to the pool must enter through the bag check line to have their bag searched before purchasing wristbands. We now accept credit cards for payment. Patrons who do not have bags, strollers, etc. may enter the pool area through the express entrance to purchase wristbands. Radios of any kind and coolers are not permitted in the pool area for any reason. Food or drinks are not permitted in the pool area except for powdered baby formula and drinking water in clear plastic containers. Food or drinks must be returned to cars or picnic areas. Sports equipment or toys of any kind, including water guns, are not permitted in the pool area. Fins, snorkels, and masks that cover the nose are not permitted. Flotation devices of any kind, including bathing suits with built-in flotation, are not permitted in the pool area unless they are Coast Guard approved. Children age 10 and under must be under close supervision, observation, and control at all times by an adult (age 18+). Children who are not toilet trained, or persons who are incontinent, must wear a swim diaper in the pool. Children s swim diapers can be purchased at the pool entrance. Clothing other than a bathing suit is NOT permitted in the pool. NO cutoffs or jeans. Properly fitted T-shirt worn over a bathing suit is allowed in the pool. Lockers are available for use. For your security, please bring a sturdy combination lock, or one may be purchased at the pool entrance. Smoking is not permitted inside the pool area and courtyard. Failure to follow the rules could result in you being asked to leave the pool area. The Park is not responsible for lost or stolen items. PARK POLICY DOES NOT ALLOW ANY REFUNDS.