1996 AGN JUL 02 I13 - Laserfiche WebLink

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CITY OF COLTON HUMAN SERVICES DEPARTMENT APPLICATION AND AGREEMENT FOR FACILITY USE REQUEST FOR USE OF Flemming Park F odd ON (DATES) July 7 Sunday 6PM (Circle One)' ❑ Baseball Diamond ❑ Pool ` TIME OF USE FROM ' OU AMP.M TO 9:00 AM P. 1. Purpose of Activity: Follow Up March for Xavier Cactrn 2. Expected Attendance: Adults Unknown Youths Unknown 3. is Activity Open to the Public: Yes X No 4. Will Admission Be Charged: Yes No 5. Will Donations Be Accepted Yes in X U If yes, what will the proceeds be used for? Application For Facility Approved De By Approval Is Subject To Conditions Listed On Back Fee White - office Yellow - Permittee PING • Fseil'dy GetderroE • Public Works We hereby certify that we shall be personally responsible, on behalf of our organization for any damage or unnecessary abuse of buildings, grounds or equipment through the use Of said premises by our organization. WE AGREE TO ABIDE BY AND ENFORCE THE RULES AND REGULATIONS OF THE CITY OF COLTON AND CERTIFY THAT WE HAVE READ THE RULES AND REGULATIONS ON THE BACK OF THIS APPLICATION. Name of Organization Living Springs Fellowship Name (pleas nt) Roy—§. Martinez Signature 'r Title Pastor Address —301 Nnrrh 7th St City,ZpCode Colton Ca. 92324 Phone (daytime) 909 894-5994 Date .Tune 12 '1996 DEPARTMENT USE ONLY Remarks CITY OF COLTON NEIGHBORHOOD SERVICES C -4-4k 16/ `i JJ ;,1 r Data Paid 19 Date Processed ,19 FACIUTIE D EQUIPMENT REQUESTED O Multi -Use Room CI Banquet Tables p ❑ Activity Room ❑ Chairs 8 ❑ Community Room ❑ P.A. System ❑ Kitchen ❑ Other ❑ Baseball Diamond ❑ Pool ` TIME OF USE FROM ' OU AMP.M TO 9:00 AM P. 1. Purpose of Activity: Follow Up March for Xavier Cactrn 2. Expected Attendance: Adults Unknown Youths Unknown 3. is Activity Open to the Public: Yes X No 4. Will Admission Be Charged: Yes No 5. Will Donations Be Accepted Yes in X U If yes, what will the proceeds be used for? Application For Facility Approved De By Approval Is Subject To Conditions Listed On Back Fee White - office Yellow - Permittee PING • Fseil'dy GetderroE • Public Works We hereby certify that we shall be personally responsible, on behalf of our organization for any damage or unnecessary abuse of buildings, grounds or equipment through the use Of said premises by our organization. WE AGREE TO ABIDE BY AND ENFORCE THE RULES AND REGULATIONS OF THE CITY OF COLTON AND CERTIFY THAT WE HAVE READ THE RULES AND REGULATIONS ON THE BACK OF THIS APPLICATION. Name of Organization Living Springs Fellowship Name (pleas nt) Roy—§. Martinez Signature 'r Title Pastor Address —301 Nnrrh 7th St City,ZpCode Colton Ca. 92324 Phone (daytime) 909 894-5994 Date .Tune 12 '1996 DEPARTMENT USE ONLY Remarks CITY OF COLTON NEIGHBORHOOD SERVICES C -4-4k 16/ `i JJ ;,1 r Data Paid 19 Date Processed ,19