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City of Colton <br />Parks, Recreation & Family Services Department <br />APPLICATION FOR FACILITY RESERVATION <br />Application For: Banquet Hall _ Meeting Room Athletic Field _ Aquatics Facility _ other <br />Requested Facility(s): Nerr7, ?-7.-1 4)G R <br />Requested Date(s) (Day/Date): tvc (o d2Qp u2Da� <br />Set -Up Time: (jU t4 Oljj I Program Time: .2,,&-o to Clean -Up Time: �: 0V to <br />Group/Organization: <br />Contact Person: YI/ r// !C <br />Date Re¢eived/Imttals % <br />Alternate Contact Person: 6n rad o 2(s <br />Address: �33 � j Wri <br />�/� �/�i /5'O <br />Address: es -1 S, M+. Vnoy-) JR( SNIt� <br />City & Zip Code: <br />ApprovaUDate: Facility Notified/Date: <br />City & Zip Code:(for <br />Home Phone:$} -(oS7 U <br />Phone: `j to —1 Z!( Z- <br />Home Phone: Y)dt-+- ol(o t-( <br />Work Phone: `7 7 7-,S 1407 <br />Estimated Total Event Attendance: Adults Teens Children <br />Reason for Use: PSA }'fir'&1/fJ% <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 />RENTAL AGREEMENT <br />_ Field Preparation <br />pm _ Bases <br />pm _ P.A. System <br />UWe 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 <br />that we have read the rules and regulations listed on the back of this application. <br />Signature of Applicant: ayt4 -�- Date: +a4 & O <br />ip.� "fr.'. It.. n.M <br />'x <br />Date Re¢eived/Imttals % <br />Payment Due Date <br />,(%! a„' <br />ApprovaUDate: Facility Notified/Date: <br />Reservation Fee <br />Security Required Venfied <br />Cleaning Deposit <br />_ z r�rt xF <br />77 <br />Insurance Required Ctertfcdr� rt <br />Date Applicant Notified <br />z��,, <br />Receipt Number <br />' <br />Copies <br />Staff Initials/Date <br />y:. <br />Remarks: <br />White: Office Yellow: Facility Green: Maintenance Pink: Patron <br />