For Office Use Only Slip #: _______________ Finger Lakes State Parks Receipt #: _______________ Transient Marina Slip Application Issued By: _______________ Date Issued: _______________ $Amount Paid: _______________ Payment Method: _______________ _______________ Reservations o Contact the park office directly for reservation information and dates when applications will be accepted. o Slips can be reserved for a minimum of 1 or 2 nights depending on the facility with a maximum continuous stay of 14 nights. o Full payment must be made at the time of the application and returned to the park address listed on the back of this application. Make checks payable to NYSOPRHP . Include payment with a self-addressed and self-stamped envelope Cancellations o Cancellations made 8 days prior to scheduled arrival date will result in a revenue credit equal to the original payment less the non-refundable reservation fee and the applicable reservation cancellation fee. No additional (agency) service or proceeding fees shall be assessed. o Cancellations made less than 8 days prior to the scheduled arrival date will result in a revenue credit equal to the original payment amount less the non-refundable reservation fee, the applicable reservation cancellation fee, and an additional fee equivalent to one-night’s transient fee (to include all surcharges, and electric fees as applicable). o For “early outs”, the amount of the revenue credit shall be determined in the same manner as cancellations (including the one-night penalty and applicable processing fees). o Late arrivals and no shows are not eligible to receive revenue credit. Check –in o All boaters must check in at the office before occupying the slip. o Check in time is 3pm. o Check out time is 11am following the last night of your stay. Marina Policies and Procedures o Boat trailer storage will be available in designated areas only. o The park reserves the right to assign or re-assign slips in order to efficiently utilize all available slips. o All park rules and regulations as well as applicable State and Federal rules and regulations will be observed. Parks reserves the right to terminate, without prior notice or refund, any permit issued when rules and regulations are violated. o Pet owners must present a current Certificate of Rabies Vaccination for all pets at the time of registration. All pets must be caged or under control on a 6 foot maximum leash at all times. o Water and electrical accessories must be approved by the Park Manager. Water may not be available during early or late season . Modification of park electric equipment and supply is prohibited o The permit holder assumes all risks related to this permit and shall be solely responsible and answerable for in damages for all accidents or injuries to persons or property, and hereby covenants and agrees to indemnify and keep harmless the People of the State of New York; Office of Parks, Recreation and historic Preservation; their officers and employees; from any and all claims, whether direct or indirect, arising out of the operation of this permit, or the carelessness, negligence or improper conduct of the Permit holder or any servant, agent or employee thereof. o The office of Parks, Recreation and Historic Preservation shall not be responsible for property damage or personal injury to the Permit Holder, or any person upon the premises at the invitation of the Permit holder. Today’s Date: ______________ [Reservation #: ___________________________ Camp Site #: _____________] Name (print): ______________________________________ [Access Pass #: _________________________] Address: ____________________________________City: ___________________ State: ______ Zip: ___________ Home Phone: (________)____________________ Cell Phone: (________)_____________________ Vehicle Make: _____________Color: ___________ State/Plate #: _______________Trailer Plate #: _____________ Boat Registration #: ____________________ Boat Make: ___________________ Boat Name: _________________ Boat Color: _________ Boat Year: _______ Length: ________ft. Beam ________ft. Slip #: _________ Type of Boat: [ ] Power Boat [ ] Sail Boat Type of Slip: [ ] Electric Slip [ ] Non-Electric Slip First Night (arrival) ___/____/____ Departure Date ___/____/____ # of Nights __________ Fees Transient w/o Camping w/ Camping Access Pass Holders (Only if pass not used for camping) Base Rate $15 x ______nights = $12 x ______nights = n/a Electric Fee $6 x ______nights = $6 x ______nights = $6 x ______nights = Weekend/Holiday $4 x ______nights = n/a $4 x ______nights = Out of State Surcharge $5 x ______nights = n/a n/a Reservation Fee $9 n/a $9 Walk-in Fee $2.75 n/a $2.75 TOTAL= Signature: _________________________________________ Date: ________________________ Keuka Lake State Park Sampson State Park 3560 Pepper Road 6096 Route 96A Bluff Point, NY 14478 Romulus, NY 14541 (315) 536-3666 (315) 585-6392 Taughannock Falls State Park 2221 Taughannock Park Road Trumansburg, NY 14886 (607) 387-6739 .