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City of Colton <br />Parks, Recreation & Family Services Department <br />APPLICATION FOR FACILITY RESERVATION <br />i <br />Appucation ror: 19aR uet riau meeting xoom Htnteuc rlela Aquatics racuit — Vmer <br />Requested Facility(s): <br />Requested Date(s) (Day/Date): <br />Set -Up Time:o �� Program Time: (®' 3j to - Clean -Up Time: to $ ,' <br />Group/Organization: <br />hj[ S^('r246 <br />Contact Person: '--6TJ —("--r <br />Alternate Contact Person: <br />Address: ( <br />Address: 91 <br />o(o3 ( u t\jDetJAve <br />City & Zip Code: S , C A- ii <br />L <br />City & Zip Code: <br />Home Phone: �-7 -7' A <br />Work Phone:261,loq1I <br />Home Phone37?j— 19Z-ppp <br />I Work Phone: qq— qB <br />Gleaning Deposit <br />Estimated Total Event Attendance: Adults 2-C> Teens Children <br />Reason for User A ✓ �( �f{Q <br />Equipment/Services Requested: # of Tables _ Athletic Lights _ Field Preparation <br />(subject to availability) # of Chairs times: from: pm _ Bases <br />_ Kitchen/Concessions to: pm_ P.A. System <br />Additional Request(s): PC�`t'n�mS / pbweR T eijiFo 0rJ <br />RENTAL AGREEMENT <br />I/We hereby certify that we shall beR11 <br />ally responsible, on behalf of our group/organization, for any damage or abuse of buildings, <br />grounds, fields, equipment, or otheres thro h th use fse f sai� by our group/organization. IfWe agree to abide by and enforce <br />the rules and regulations of the Cityton and eyti th ve rea a rules and regulations liste4 on the back of this application. <br />Signature of Applicant: <br />Wnr tlfkir . iise Onlvl <br />Date: <br />Remarks: —0tG- d14!,(once <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 />r t� <br />Gleaning Deposit <br />Insurance Required <br />Date Applicant Notified <br />Copies <br />- <br />Receipt Number <br />Staff Initials/Date <br />Remarks: —0tG- d14!,(once <br />White: Office Yellow: Facility Green: Maintenance Pink: Patron <br />