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City of Colton <br />Parks, Recreation & Family Services Department <br />APPLICATION FOR FACILITY RESERVATION <br />Hall <br />Athletic Field <br />Requested Facility(s): 4:"Lc-iy I A/6— YO,4/2 K <br />Requested Date(s) (Day/Date): A,(4 i/ / F J Z 0 O z <br />Other <br />Set -Up Time: 7,'3 U to L?., Crp I Program Time: 8'OD to x.'30 I Clean -Up Time: y, to /0. 'CrD <br />Group/Organization: UA.), % AR A t/ E /2 M 4 /2 c /-L <br />Contact Person: 'Su p v <br />Alternate Contact Person: 34 LG e C3 fi/2 CL "9 <br />Address: ( 6 O e p LTO nJ R U t; <br />Address: 6 (, O C70 L I D Al ,4 a <br />City & Zip Code: eg LTU n) q 7-3Z4 <br />City & Zip Code: 2-3 Z y <br />Home Phone: <br />I Work Phone: 3 70 (o Q <br />Home Phone: <br />I Work Phone. -3 <br />Estimated Total Event Attendance: <br />-2'5- <br />Adults <br />/ Teens /�_ Children <br />Reason for Use: -UAI r T <br />P2 <br />Approval/Date: Facility Notified/Date: <br />A- f *,Cl C-, <br />Equipment/Services Requested: # of Tables <br />(subject to availability) /Oa # of Chairs <br />_ Kitchen/Concessions <br />Additional Request(s): <br />— Athletic Lights <br />times: from: _ <br />to: <br />RENTAL AGREEMENT <br />_ Field Preparation <br />pm _ Bases <br />pm -D< 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 Colton and certify that we have read the rules and regulations listed on the back of this application. <br />Signature of Applicant: 0 Y oa cls C Date: o? O Z - <br />[V., nen,.. IT. nnt.i <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 <br />— Y eq `t. w <br />Cleaning Deposit <br />Insurance Required ` <br />Applicant Notified <br />— W tp, , � � .az,N , <br />Date <br />Receipt Number. <br />Copies <br />Staff Initials/Date <br />Remarks: <br />White: Office Yellow: Facility Green: Maintenance Pink: Patron <br />