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E <br />Annlication Fnr- <br />City of Colton <br />Community Services Department <br />APPLICATION FOR FACILITY RESERVATION <br />Rnnnuet Hall MP.P.tlnn Room Athletic Field Aquatics Facilitv /V Other <br />Requested Facility(s): F 4ern l }Ark. <br />Requested Date(s) (Day/Date): <br />Set -Up Time: OJA` to 3 t11 <br />Program Time: <br />"% to M <br />Clean -Up Time to <br />Group/Organization: coll*1111 Co r Nk Services <br />Contact Person: —r- <br />Alternate Contact Person: <br />Address:(010I h <br />Address: <br />City & Zip Code: CO "tell Ck ga3a <br />City & Zip Code <br />Home Phone: <br />Work Phone: &7o..s 4, <br />Home Phone: <br />Work Phone: <br />Estimated Total Event Attendance: JQQ Adults00 Teens Children <br />Reason for Use: Bx"ie &P—ONe 5„r)AQ <br />Equipment/Service Requested: # of Tables Athletic Lights <br />(subject to availability) # of Chairs times: from: pm <br />Kitchen/Concessions to: pm <br />Additional Request(s): <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. IANe agree to abide by and enforce the rules <br />and regulations of the City of Colton and certify that we have read the rules and regulations listed on the back of this application. <br />Signature of Applicant: <br />PERMIT NUMBER <br />Security Required <br />Insurance Required <br />Copies <br />Remarks: <br />r Date: ielbl'LIII.MA Is, amp <br />(For Office Use Only) <br />Payment Due Date <br />Facility Notified/Date <br />Reservation Fee <br />Cleaning Deposit <br />Date Applicant Notified <br />Receipt Number <br />Staff Initials/Date <br />White - Office Canary - Facility • Green - Maintenance • Pink - Patron <br />