Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Permit for Beach/Park Wheelchair

  1. City of Atlantic Beach, FL
  2. Area Code Required with - between numbers
  3. If different from Cell Phone
  4. If you are wanting to reserve a wheelchair for use on the beach, please indicate the beach access you would like the wheelchair to be dropped off.

  5. Please indicate the times and dates you will need the wheelchair.

  6. Beach Wheel Chair Reservation
    Click here to reserve Beach Wheelchair
  7. Public Facility and Public Areas Disclaimer*
    All public facility and public areas should be left in good and clean condition without damage. ALL CITY POLICIES AND ORDINANCES ARE TO BE FOLLOWED. If weather is inclement, events may be rescheduled up to 30 days after submitted date of event upon notification to the Recreation Office. NO REFUNDS will be issued! For fires - charcoal, wood and any remnants of the fire must be removed from the beach, the area picked up and trash deposited in trash barrels or removed. Applicant agrees not to sell, publicize or discuss any products or services offered by self, or any organization, or to engage in fundraising activities on public property of the City of Atlantic Beach including park and beaches. Use of alcoholic beverages is not permitted in the City parks or on the beach.
  8. Applicant Signature
    The APPLICANT shall indemnify, defend and hold harmless the City of Atlantic Beach, its officers, employees and agents from any and all losses, costs, expenses, claims, liabilities, actions, or damages, including bodily injury and personal injury liability for injuries to any person or persons or damage to property arising at any time during and/or arising out of, or in any way connected with APPLICANT'S use of CITY/PUBLIC property, unless solely caused by the gross negligence of willful misconduct of the City, its officers, employees or agents. By signing this application, the APPLICANT has read and agrees to accept all responsibility outlined and implied to comply with the Ordinances and Codes of the City of Atlantic Beach, the Special Event Guidelines and Policies, and all requirements stipulated for approval of this application.
  9. Applicant must be 21 years of age, (proof of Driver's License Required) This serves as an electronic signature and acknowledgement of above Disclaimers
  10. Total Amount Due $______________

    For Office Use Only: Paid $ ___________ Receipt # _____________ FOP: Ck # ______ Cash ______ CC _____

  11. Office Use Only:
    ID verified _______ Approved _______ Denied ________
  12. Leave This Blank:

  13. This field is not part of the form submission.