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City of Colton Community Services Department APPLICATION FOR FACILITY RESERVATION Annlinafinn C'nr• Rnnnnat Hall Mpptinn Rnnm Athletic Field Aouatics Facilitv"Uther Requested Facility(s): Dat AecetYedttniti Requested Date(s) (Day/Date):A101 PERMIT NUMBER (✓iIt�Y Set -Up Time: to Program Time: to C i Clean -Up Time . to 1 _ Insurance Required < - Vedfiied " = Date Applicant Notified Group/Organization: n ; Contact Person: leJll�r Alternate Contact Person: . tA Address: go rC5 Address: �---- City & Zip Code: City & Zip Code — Home Phone: Work�P��o/n� . Home Phone: Work Phone: t Estimated Total Event Attendance: tyy Adults _fn_ Teens Children Reason for Use: Equipment/Service Requested: (subject to availability) # of Tables # of Chairs Kitchen/Concessions Additional Request(s Athletic Lights times: from: pm to: pm RENTAL AGREEMENT I/We hereby certify that we shall be personally responsible, on behalf of our group/organization, for any damage or abuse of buildings, grounds, fields, equipment, or other facili ' throu h the use of said premises by our group/organization. I/We agree to abide by and enforce the rules and regulations of the City of n an ertify th t w d fla rules and regulationssslliisteed on the back of this application. Signature of Applicant: r Offic Use Only) ��-"' White - Office Canary - Facility Green - Maintenance Pink - Patron Dat AecetYedttniti Payment Due Date PERMIT NUMBER Facility Notified/Date Reservation Fee — Security Required = Verified, " Cleaning Deposit _ Insurance Required < - Vedfiied " = Date Applicant Notified Receipt Number ; Copies " Staff Initials/Date White - Office Canary - Facility Green - Maintenance Pink - Patron