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City of Colton <br />Parks, Recreation & Family Services Department <br />APPLICATION FOR FACILITY RESERVATION <br />Application For: Banquet Hall Meeting Room Athletic Field Aquatics Facility Other <br />Requested Facility(s): <br />Requested Date(s) (Day/Date): 5 „Q� i j 24nD <br />Set -Up Time: 5;So to $ : Program Time: :06 to �; Clean -Up Time: 7: Mto $ <br />Group/Organization: el <br />Contact Person: �� <br />Alternate Contact Person: <br />Address: CAAddress: <br />►(� <br />City & Zip Code: L6 CAC ctv5v� <br />City & Zip Code: <br />C&riiL2 2 <br />Phone: rf _1JI <br />Work Phone: X <br />Home Phone: N <br />Work Phone: k565iL <br />Estimated Total Event Attendance: 20P— Adults 2 5 Teens 25 Children <br />Reason for Use: <br />Equipment/Services Requested: 2t # of Tables _ Athletic Lights _ Field Preparation <br />(subject to availability) 10 # of Chairs times: from: pm _ Bases <br />Kitchen/Concessions to: pm —�.A. System <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, <br />grounds, fields, equipment, or other facilities through the use of said premises by our group/organization. I/We agree to abide by and enforce <br />the rules and regulations of the CityR f Colton aat,ntd�, certify that we have read the rules and regulations listed on the back of this application. <br />Signature of Applicant: /l/Jf/1lVtl V- 6"/), Qr Date: 7,&— Q .0 ' <br />;is,Raxivedtioitials 7 T?L1 `r$ Payment Due Date <br />Approval/Date: Facility Notified/Date: Reservation Fee <br />_ Security Required Veri6ad:i Cleaning Deposit <br />Insurance Required-,Veiitted Date Applicant Notified <br />Copies <br />Remarks: <br />Receipt Number <br />Staff Initials/Date <br />White: Office Yellow: Facility Green: Maintenance Pink: Patron <br />