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City of Colton <br />Parks, Recreation & Family Services Department <br />APPLICATION FOR FACILITY RESERVATION <br />Requested Facility(s): Fl /A/6- / fq'g KV Pf/iTffM7R6_ <br />Requested Date(s) (Day/Date): S(Z)4 H " <br />L <br />X03 '' <br />Set -Up Time: %/"a*M to �a 111 Program Time: �a. �;� o .940 IOM Clean -Up Time: 9-J0,014 to y4// <br />aei/17 <br />Group/Organization: j3R0I1JA/!E TROOP #'131 (&IRI- Sceurs as,# <br />Contact Person: lwlm j/J <br />GL/Ji/it/0 <br />Alternate Contact Person: &T/j<E InC4'�lje't) <br />Address: a37% ff (,IFF <br />ST <br />Address: 17!5")- If /JA/Di1G4 <br />City & zip Code: 0,01,'6) <br />ya3 <br />City & zip Code: CozrOhJ 913% <br />Home Phone: ff yff S63 <br />Ce <br />}li4A Phone:`%iG S/S5 <br />Home Phone: <br />Work Phone: <br />Estimated Total Event Attendance: _,4_0 Adults / 6 Teens Jr Children <br />Reason for Use: f}6c00T e,,eW-&M9A-11 <br />Equipment/Services Requested: # of Tables <br />(subject to availability) _ # 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 X 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: r Date: 1/ 11103 <br />Remarks: <br />White: Office Yellow: Facility Green: Maintenance Pink: Patron <br />