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City of Colton <br />Parks, Recreation & Family Services Department <br />APPLICATION FOR FACILITY RESERVATION <br />Hall <br />Requested Facility(s): <br />Requested Date(s) (Day/Date): <br />Field <br />Other <br />Set -Up Time: 4:oo to 15'.po Program Time: 5:00 to 2);00 Clean -Up Timeg;OD to L91100 <br />Group/Organization: G, QGC.0 UD NPAWUn±j GCNICvc <br />Contact Person: <br />Alternate Contact Person: <br />Address: <br />Address: <br />City & Zip Code: N Un 02322L <br />City & Zip Code: <br />Home Phone: <br />Work Phone: 1545 <br />Home Phone: <br />Work Phone: <br />Estimated Total Event Attendance: �Adults Teens � Children <br />Reason for Use: vAAM MW l PQ mctr--.�- ee' l6-4)- <br />Equipment/Services <br />6,4j' <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 />_ Field Preparation <br />pm _ Bases <br />pm _ P.A. System <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 grouptorganization. ItWe agree to abide by and enforce <br />the rules and regulations of the City ofIton and certify <br />/that we have read the rules and regulationslistedon the back of this application. <br />�/ <br />Signature of Applicant: i-1 Date: `C I (Q I <br />Approval/Date <br />_ Security Required <br />_ Insurance Required <br />Copies <br />Remarks: <br />Facility Notified/Date: <br />Payment Due Date <br />Reservation Fee <br />Cleaning Deposit <br />Date Applicant Notified <br />Receipt Number <br />Staff Initials/Date <br />White: Office Yellow: Facility Green: Maintenance Pink: Patron <br />