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City of Colton <br />Parks, Recreation & Family Services Department <br />APPLICATION FOR FACILITY RESERVATION <br />Application For: Ban uet Hall _ Meeting Room _ Athletic Field _ Aquatics Facility P-- Other <br />Requested Facility(s): F e- v'v`� q Po, r- < Q s'I GL <br />Requested Date(s) (Day/Date): S -P+, C u 7-o v 3 <br />Set -Up Time: to Program Time:A,rto 3 t Clean -Up Time: ,►vt , to , j ' yvl , <br />Group/Organization: )l <br />L NA lY'C So r arr D QVev'coY✓t% <br />` <br />rt -9%l d, C <br />Contact Person: �j q N �q , L p Fe, 21 <br />Al mate Contact Person: <br />ReasonforUse: <br />Address: II 3 N. CTrand <br />Address: <br />4r+s <br />City & Zip Code: Co '�O h Z <br />City & Zip Code: Lo Ifo VI <br />Z' f <br />Home Phone: $ Z,Y-O,S <br />Work Phone: 9 376,5' <br />Home Phone: $ L�� p � <br />Work Phone: 6�{S-ZT76 <br />Estimated Total Event Attendance:� <br />Adults <br />IY—V Teens <br />�z-.5 Children <br />ReasonforUse: <br />Fe5fVal <br />Of <br />4r+s <br />4-0 <br />yromo Q., <br />Cfitvlmiott y' <br />� <br />1 <br />Z <br />Equipment/Services Requested: <br />(subject to availability) <br /># of Tables <br /># 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 />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. UWe 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: �"��� Date: ! o 26 03 <br />White: Office Yellow: Facility Green: Maintenance Pink: Patron <br />