If you are looking for a special park permit for an event, or for a commercial photography permit, please visit the park permit page

Forms

You will need Adobe Reader to view the following files:

Authorization for Administering Medication Form (PDF) >

Complete this form to request and give permission to the Centerville-Washington Park District to administer medication to your child while attending a Park District program or camp. You must submit a new form each time there is a change in medication, dosage and/or a change in conditions under which medication is to be administered.

Epi-pen Document Packet (PDF) >

In order to provide the best possible care for your child, the Centerville-Washington Park District has adopted a policy for the administration of Epinephrine for children with severe allergies. The Epi-pen Document Packet (PDF) must be completed and returned to the Park District at least one week prior to your child attending a Park District program or camp.

If you do not wish to leave your child’s epi-pen with them at the program, please complete the Epi-pen Guardian Waiver (PDF).

Inhaler Waiver and Release Form (PDF) >
Booth/Vendor Proposal Form (PDF) >

Please complete this form if you would like to set up a booth at any Centerville-Washington Park District program or event.

Program Proposal Form (PDF) >

The Park District is recruiting contractual instructors in fitness, wellness and general craft/enrichment for all ages. Requirements include one year of formal teaching experience. Candidates with related training and experience interested in this opportunity should submit a résumé, cover letter, Program Proposal Form, and example outlines and/or portfolio items to program@cwpd.org or to: Attn: Program Instructor, Centerville-Washington Park District, 221 N. Main Street Centerville, Ohio 45459.

Sprayground Group Visit Request (PDF) >

Plan a visit to the Activity Center Park sprayground with your group or daycare. Read the information, print the request form and submit the completed form to the Park District. This form does not reserve the park shelter.

Athletic Release – 4 per page (PDF) >

Release form for participants in athletic organizations using Park District facilities.

Athletic Release (MS Word) >

Release form that can be copied into your document for participants in athletic organizations using Park District facilities.

General Release – 4 per page (PDF) >

Release form for participants in Park District programs and events.

General Release (MS Word) >

Release form that can be copied into your document for participants in Park District programs and events.

Financial Assistance Application (PDF) >

The Centerville-Washington Park District delivers fun, healthy, and outstanding park experiences that connect the community to the outdoors. We hope to provide these experiences for all members of the Centerville and Washington Township community. Financial assistance is available for residents to participate in Park District programs.