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City of Colton <br />Community Services Department <br />APPLICATION FOR FACILITY RESERVATION <br />e_... o.,.... M Lamin Ancotinn Rnnm Athletic Field Aquatics Facilitv Other <br />Requested Facility(s): Q <br />Payment Due Date <br />Requested Date(s) (Day/Date):�y <br />Set -Up Time: _ to 4: Program Time: �; <br />I mlo <br />bb Clean -Up Time:ll• to <br />9 <br />Reservation Fee <br />., <br />Security Required <br />Cleaning Deposit <br />Group/Organization: <br />C- <br />Contact Person:73�i,!�A N;?'DAH �Z <br />Alternate Contact <br />Person: ` <br />Address:'Lj51 PmCJW3+A j}. <br />Address: 145-1 <br />City &Zip Code:?em( <br />City & Zip Code <br />23 <br />Hge: ork P one: ri _ <br />359 <br />I r Gn <br />ork hone: <br />Estimated Total Event Attendance: 15D Adults <br />Children <br />p �Tepeens' <br />Reason for Use: <br />Equipment/Service Requested: <br />(subject to availability) <br /># of Tables <br /># 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 certify tha we have read the rules and regulations listed on the back of this application. <br />Signature of Applicant: Date: 141d('0 <br />ffice Use Only) <br />L1afe leceivredllnttfals= <br />Payment Due Date <br />PERMIT NUMBER <br />Facility Notified/Date <br />Reservation Fee <br />., <br />Security Required <br />Cleaning Deposit <br />Insurance Required ; „ eri ied a <br />Date Applicant Notified <br />Receipt Number <br />r <br />Copies <br />Staff Initials/Date <br />Remarks: <br />White - Office • Canary - Facility • Green - Maintenance • Pink - Patron <br />