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Aoalication For: <br />City of Colton <br />Community Services Department <br />APPLICATION FOR FACILITY RESERVATION <br />Banquet Hall Meetina Room Athletic Field Aquatics Facility Other <br />Requested Facility(s): <br />S�� <br />Adults <br />7-5 <br />Requested Date(s) (Day/Date): <br />04 C5aiCL446� <br />Set -Up Time: Igoo to /'r <br />Program(ITime:ly'pDto /�D2j <br />can -Up Time:/ifcmto /7a6 <br />C[ <br />Group/Organization: F, <br />Cleaning Deposit <br />v <br />Contact Person:Alternate <br />Contact Person: <br />Address: tqZ) Lj—� Sv`� Z�6 <br />Address: %�S 3 LtJ, S t <br />City & Zip Code: <br />Z <br />City & Zip Code Gy1 <br />Home Phone: g Z�k_ 13s ( <br />Work Phone: E2.S--25-Zo <br />Home Phonefioq <br />Work Phone: <br />Estimated Total Event Attendance: <br />S�� <br />Adults <br />7-5 <br />Teens <br />�Children <br />Si\\ <br />Reason for Use: <br />Facility Notified/Date <br />Reservation Fee <br />C[ <br />Security Required, Veitfied <br />Cleaning Deposit <br />Equipment/Service Requested: <br />(subject to availability) <br /># of Tables <br />G # of Chairs <br />Kitchen/Concessions <br />Additional Request(s; <br />Athletic Lights <br />times: from: pm <br />to: pm <br />RENTAL AGREEMENT <br />I/We hereby certify that we shall be personally responsible, on behalf of our group/organization, for any damage or abuse of buildings, grounds, <br />fields, equipment, or other facilities through the use of said premises by our group/organization. I/We agree to abide by and enforce the rules <br />and regulations of the City of Colton and certiat we hayU rules and regulations listed on the back of this application. <br />Signature of Applicant: �vva! Date: t— 36n 06 <br />(Fer6ffic Use Only) <br />i ri � StN , y: V <br />`� <br />d �4��", <br />Payment Due Date <br />PERMIT NUMBER <br />Facility Notified/Date <br />Reservation Fee <br />Security Required, Veitfied <br />Cleaning Deposit <br />Insurance Required ale"fled` ( �'* <br />Date Applicant Notified <br />Receipt Number <br />Copies <br />A° <br />Staff Initial /Daterliik <br />White - Office • Canary - Facility • Green - Maintenance • Pink - Patron <br />