Extended Stay Request Form Please answer all fields before submitting the form. Primary Adult Guest First & Last Name:(Required) Home Address:(Required) City:(Required) State:(Required) Zip Code:(Required) Primary Phone:(Required)Secondary Phone:(Required)Email Address:(Required) Vehicle Tag:(Required) Driver’s License Number and Issuing State:(Required) Vacationing or Work Stay? What type of work?(Required) Secondary Adult Guest First & Last Name:(Required) Home Address:(Required) City:(Required) State:(Required) Zip Code:(Required) Primary Phone:(Required)Secondary Phone:(Required)Email Address:(Required) Vehicle Tag:(Required) Driver’s License Number and Issuing State:(Required) Length of Stay:(Required) Check–in Date:(Required) Check–out Date:(Required) RV Year:(Required) Type of RV:(Required) Length of RV:(Required) Number of Slides:(Required) 30 or 50 Amps(Required) Number of Children:(Required) First Child's Name / Age:(Required) Second Child's Name / Age:(Required) Third Child's Name / Age:(Required) Number of Pets:(Required) Pet's Name / Breed:(Required) Pet's Name / Breed:(Required) Payment Preference: Cash Check Credit – 3% Convenience Fee with Credit or Debit Card Payments Please check each box indicating that you have read the rules and will abide them.(Required) 1. Extended Stay site reservations require a $100 non-refundable deposit which will hold your site for a maximum of 2 weeks. Your site can be reserved as early as two weeks prior to your check in date. Should you not arrive by that date, your deposit will be forfeited and your reservation will be canceled, unless you wish to pay the remaining balance on the first month’s rent. 2. Any guests staying 30 days or less are not eligible for extended stay rates. Rent for 30 days only is $800 on any site. Discounts are not offered on 30 day only rates. If you indicated you will be here longer and stay for only 30 days or less, the credit card on file will be charged the remaining $200. 3. Rates are for 1 RV unit, 2 Vehicles, 2 Adults, 2 Children and 2 pets per campsite. Any additions to this must be approved by park management and will result in increased rental rates. $5 per additional person per night. Additional vehicles are $3 per night and will be required to park in over-flow parking. Additional pets are not permitted. 4. Regular sites rent for $600-$700 per month. Your month begins the day you check in and runs for 30 days. At the beginning of the 3rd month your rent is pro-rated, based on the lesser rate of the site, until the 1st day of the next month. Your rent will then be due on the first of every month. Rent paid after the 5th day of the month is subject to a $25 late fee. 5. Premium and Super Premium Sites rent rates are between $750 - $900. The 3rd month is subject to a proration period until the 1st day of the next month based on your lot's monthly rate divided by 30 days. 6. Cash or check payments are preferred. A 3% Convenience Fee is charged for rent payments made by a credit or debit card. Upon check-in, a detailed document will be provided listing due dates and balances due. If you cannot get to the office during business hours you are welcome to put a check or money order (in an envelope) through the mail slot on the front door. 7. Sites are prorated at the end of your stay. If you only stay a portion of your last month you will be charged regular general stay daily or weekly rates. If you have already paid rent for the month refunds will not be offered. 8. Extended Stay sites are already greatly discounted from our general nightly rates. No additional discounts will be applied to Extended Stay sites. Guests need to notify the office if they expect to stay longer than initially anticipated, otherwise the site may be rented to another guest and you will need to vacate the site. 9. All Extended Stay guests must have a credit card on file with our office to which unpaid balances will be charged on the 6th day past the day your rent is due and include a $25 late fee plus 3% convenience fee. 10. Rent includes electricity up to $75 (500 kwH). Any amount over $75 will be due with your rent. This charge will be 15 cents per kilowatt hour. Site meters are read at the end of each month prior to rent being due. Site rent also includes sewer, water, and Wi-Fi. Park Wi-Fi is not intended for streaming television or large file downloads. Cable Internet is not provided but may be available through Wind Stream. Do not permit any personnel with any company that you hire to dig holes, cut trees, or damage park property in anyway. You will be responsible for their damages. 11. CAMPSITES: Campsites must be kept garbage and litter free. Be sure to keep all personal items underneath your RV in plastic tubs with lids. No clothes lines are permitted. Please utilize the dumpsters as trash cans are not permitted on RV sites. No landscape changes (building structures or planting) are to be done to any site without prior permission. No A/C window units, washers, dryers, refrigerators or freezers allowed outside of RV's. No tarps over RV's. RV’s may not be underpinned/skirted. No rugs on grass – rugs may be placed on gravel. Do not drill or nail into picnic tables or trees on site. Do not remove provided fire rings. Storage sheds are not permitted within the campground. Do not dig holes on sites. No TENTS allowed. 12. MAINTENANCE: All RV's must be kept clean and in good repair in order to maintain your status as our guest. Guests are required to wash their RV once per year or as requested by Park Management. If repairs are made on-site the work must not disrupt other guests. Guests who do not maintain their RV's may be asked to vacate the campground. No major mechanical work is to be done on any vehicle or RV, on any campsite. 13. VISITORS: Each guest is responsible for the conduct of their visitors. There will be a $5.00 charge per additional overnight guest/visitor. Guests are responsible for informing their visitors of the campground rules prior to their visit. Visitors who do not follow the rules will be asked to leave and not permitted to return. All guests and visitors of guests must maintain a speed limit in the campground of 10 MPH or less. This rule is strictly enforced. Watch out for small children and pets. VISITORS OF GUESTS MAY NOT USE THE AMENITIES OF THE PARK INCLUDING THE SWIMMING POOL, FISH POND, BATH HOUSE, AND LAUNDROMAT. 14. PETS: All pets must be kept on a leash of 6’ or less. Adjustable length leashes (Flex leads) are not permitted. NOTE: A Maximum of 2 pets. Dog breeds known for aggression are not permitted including Pit Bulls, Dobermans, and Rottweilers of any mix. You must pick up after your pet. We have 7 “Pet Stations” for your convenience and they are indicated on our map. A fee of $25 will be enforced per Poo Violation. Pets may NEVER be left unattended outside your RV. Pets are not permitted inside the pool area, laundromat, bathrooms or showers rooms. Pet kennels or fencing, of any kind is not permitted on a site. Outdoor cats are not permitted. Owners of loose pets will be fined $50.00 per violation. Any animals found loose in the park will be reported to White County Animal Control. If you see a stray or loose animal please take a photo and email it to us. Repeat violators of pet violations will be asked to vacate the campground. No Pet Snakes! Owners of dogs who constantly bark will be fined $50. Other guests will not be expected to listen to your barking dog!!! ANY CONTINUOUS PROBLEMS WITH PETS WILL RESULT IN YOUR BEING ASKED TO LEAVE OR REMOVE THE PET. 15. VEHICLES: Each extended stay site is allowed two (2) working passenger vehicles in addition to their RV. Extra trailers will no longer be permitted on Extended Stay sites with the exception of car haulers and motorcycle trailers. These trailers MUST fit on the gravel on your site. Otherwise you will be required to store it off site. Cargo trailers, utility trailers, boats and other extra trailers will not be permitted. No extra trailers are permitted AT ALL if you already have two passenger vehicles on the site. A total of 2 vehicles in addition to your RV is the maximum per site! We simply do not have the room for them. A $90 fee will accompany violations of this rule. Vehicles must be kept clean but may not be washed in the park. $10 wash fees are for your RV ONLY. Vehicles may not be parked on the grass anywhere in the park. You may only park on gravel. Vehicles must fit within the obvious parameters of the site, so as not impede the flow of traffic or overhang on to other sites. 16. PARKING: No parking in front of the office! Office business is permitted only on the east side of the office building near the stairs. We cannot allow congestion in the driveway as it can cause accidents on Westmoreland Road. We will refuse you service until you park appropriately. No parking on or driving through empty sites is permitted. If no space is available on your personal site, additional vehicles are $3 per night and may be asked to park in temporary over-flow parking on the north side of the campground. When parking anywhere on the property be considerate of other guests in that an RV my need to pass. When parking at the Laundromat please use common sense including not parking on the concrete, blocking the doors or blocking other drivers from parking too. 17. LAUNDRY/ BATHHOUSE: Dish washing is not permitted in the laundromat, bathrooms or shower stalls. Laundry soap pods are prohibited as they clog our machines. Machines all require High Efficiency (HE) laundry soap as regular soap causes flooding. Pet Bedding, comforters or large blankets may NOT be washed at Leisure Acres. When utilizing the laundry facilities guests MUST remain at the laundromat through the entire washing and drying process. We are not responsible for items left unattended. Messy guests will not be permitted to use the facilities. Clean up after yourself or understand that we will have to ask you not to use the facilities! Please check the washers and dryers after you use them and remove any hair, fur or lint. If you would not put it in your washer, please do not put it in ours! Leave it better than you find it and we will all benefit. Extended Stay guests may use the showers for an additional fee of $5 per person, per day. 18. PROPANE: No propane tanks larger than 40 lbs., or equivalent of 80 lbs. total on each RV – per county ordinance. Propane Tanks will be filled at 4PM each day. Please pre-pay for your tank to be filled at the office and obtain a 'paid' sticker prior to 4PM. Place the sticker on your tank and put the tank inside the chain link area at the filling station. After your tank has been filled it will be left outside of the gate. Please be certain and tag your tanks with your information in ink or paint so ownership is readily identifiable. 19. WINTER / WATER: We require a properly installed heated water hose be placed on your site from November 1 to April 1. Additionally, DO NOT allow your faucets (inside or outside) to drip to prevent them from freezing. Doing so will result in fines of $100 per violation. Heated water hoses must be a product sold as a heated water hose and may not be homemade. They must have a built-in thermostat in order to be approved. Heated hoses are for sale on Amazon for about $100 depending on the length that you will need. Also, if you have a water filter, know that if it is not insulated it will likely burst. You will also need to insulate the connection on the side of your RV. The spigot on each site will be insulated with Reflectix material. After we do this please ensure it is sealed tightly again if you access the spigot this winter. The use of a threaded sewer connection is required to prevent liquid and gas leaks. Damaged sewer hoses must be replaced accordingly. Site inspections will be performed periodically by maintenance personnel to ensure that all guests follow the standards required by the county and state health department. All black and gray sewage waste must be emptied into the sewer station at your site. Black water sewer valves must be kept closed unless you are actively emptying the tank. Black water sewer valves must not be allowed to drain constantly as this will cause a pyramid in your tank that other guests must smell too and will result in a $50 fine per violation. 20. Alcoholic beverages must be kept within your own campsite and are not permitted anywhere else in the campground. No exceptions! 21. ONLY guests with registered driver’s license may operate golf carts on the property. No scooters, ATV’s/UTV’s or motorized bicycles are allowed. 22. Quiet Hours: 10:00PM to 8:00AM – This includes your vehicles, your pets as well as your visitors. Remember RV walls are thin. 23. Leisure Acres Campground is not responsible for the delivery or pickup of packages at the campground. Leisure Acres Campground will not accept mail for Extended Stay. We recommend Extended Stay obtain an United States Postal Service P.O. Box for the receipt of mail. 24. NOTE: This property is privately owned. Extended stay rates do not constitute a lease. No rights of tenancy are conveyed. We reserve the right to refuse service to anyone. We are not responsible for accidents or injury to our guests or visitors. We are not responsible for guests’ property losses, damages or theft. We do recommend that our guests maintain RV insurance to protect their investments. All other rules and regulations still apply and can be found on our website: leisureacrescampground.com - Please contact the campground office if you have any questions or concerns. By signing, you acknowledge that you agree to all the rules of Leisure Acres Campground and intend to abide by them as our guest. 25. Photographs are required for ALL RV's regardless of age. Submit photos of all 4 sides in good light. Photos shall be sent to: firstname.lastname@example.org. If your rig needs to be washed, we suggest doing so prior to taking the photos as dirty RV's will not be approved. If photos do not match photos provided when you arrive, we reserve the right to refuse your stay. Rent paid late is subject to $25.00 late fees for every five days it is late.Electronic Signature and Acceptance(Required) By checking this box, I acknowledge and agree the information in this form is correct and I agree to abide by the terms and conditions set forth. This electronic signature shall be considered as an original signature for all purposes and shall have the same force and effect as an original signature.