Laserfiche WebLink
City of Colton <br />Parks, Recreation & Family Services Department <br />APPLICATION FOR FACILITY RESERVATION <br />FLF44/A)5 PAJ2.,t: <br />A lication For: Banuet Hall Meetin Room Athletic Field Aquatics FacilityOther <br />Requested Facility(s): j=L--It^ I I%/ c., PAit C C) L"/-Ojrj <br />Requested Date(s) (Day/Date): <br />Aj <br />0 ()7-- <br />I Set -Up <br />7— <br />Set-Up Time: 4, to 7 '- <br />M (-Program Time: 7 to 9 to '�' I Clean -Up Time: I to 9 3a <br />Group/Organization: j-A,.q i L i zS i'D Amc�,jN c -At- Ft 1t-nJ,A- Tt4iLt;S % 1 /CCS <br />Contact Person: (-c7 S E <br />SAo J art_ <br />Alternate Contact Person: 'gAft'� ELta S <br />Address: p� s E. (d <br />S?' <br />Address: r2 y 3 rt E71, r -b, er J <br />City & Zip Code: C -z Lq-trJ cj Z3 2 If <br />City & Zip Code: S f4vJ <br />Home Phone: '51 q • /9 6 3 <br />Work Phone: <br />Home Phone: q ( S - v-7 6 <br />Work Phone: 519-Y0.36 <br />Estimated Total Event Attendance: 15— Adults Teens / Children <br />Reason for Use: <br />Equipment/Services Requested: y # of Tables <br />(subject to availability) # of Chairs <br />_ Kitchen/Concessions <br />Additional Request(s): <br />Athletic Lights <br />times: from: ! pm <br />to: 17 pm <br />_ Field Preparation <br />_ Bases <br />P.A. System <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 City of Coltop and certify that we hays; th q les and regulations listed on the back of this application. <br />y � <br />Signature of Applicant: 2 de � ._ � ,Ccs Date: Sv tJ E- l 01 0 Z <br />(Fnr nffire Ilse nolv) <br />Remarks: <br />White: Office Yellow: Facility Green: Maintenance Pink: Patron <br />Payment Due Date <br />Approval/Date: Facility Notified/Date: <br />Reservation Fee <br />Security Required etl <br />Cleaning Deposit <br />_ Insurance Required C(tad•' . <br />Date Applicant Notified <br />Receipt Number <br />Copies <br />Staff Initials/Date <br />Remarks: <br />White: Office Yellow: Facility Green: Maintenance Pink: Patron <br />