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City of Colton <br />Community Services Department <br />APPLICATION FOR FACILITY RESERVATION <br />U-11 0�'� Afhlti� Piairl Amintinq Far.ilitv Other <br />Requested Facility(s):..,,t, a -r <br />.,g_r <br />__4!� <br />Requested Date(s) (Day/Date): <br />Set -Up Tims�,,,Q, ..4to Z& ppr� <br />Program Time �kbo to <br />Clean-UpTime:2�bto 91V61) <br />Group/Organization:(OLrVA/ Ace -sr <br />'4s56WA6(x 0,-' 606_� <br />Contact Person: '*'r- 41,4V64�o <br />Alternate Contact Person: <br />Address: sc5v W, cim/iS, CaCrDX1_ <br />Address: <br />City & Zip Code: C 0 Lrb'y 2,32Y <br />City & Zip Code <br />_—] <br />Home Phone <br />?Ly-%-7L� <br />Work Ph e: <br />Ing <br />RQ�0) <br />Home Phone: <br />o�rk <br />Phone�.� <br />Estimated Total Event Attendance: <br />Adults Teens J Children <br />Reason for Use: <br />EquipmenttService Requested: # of Tables Athletic Lights <br />(subject to availability) # of Chairs times: from: — pm <br />Kitchen/Concessions to: pm <br />Additional RequeSt(S)7 <br />Ad 44( 4az�Le5'r-5 <br />RE TAIL AGREEMENT <br />l/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. [Me 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: �� dkixdz:�Q —Date: <br />(For Office Use Onlv) <br />Remarks: <br />White - Office - Canary - Facility - Green - Maintenance - Pink - Patron <br />