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1 <br />1 <br />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): <br />Requested Date(s) (Day/Date): o(cfoL9"'C200i v <br />Set -Up Time: Program Timer'; to 8 "C)3 Clean -Up Time: to <br />Group/Organization:pe4-t�cn4-bac' <br />Contact Person: <br />aluenk 6-� <br />euy Alternate Contact Person: Vri's Ar/ <br />Address: q? --9 <br />~ jr� f <br />Address: <br />City & Zip Code:( 92 <br />City & Zip Code: ,9 ZZ <br />Home Phone: - <br />Work Phone: a ZS,5,ql 7 <br />Home Phone: S-/.,/ <br />Work Phone: <br />Estimated Total Event Attendance:Adults <br />Payment Due Date <br />_7-.-:C-Teens <br />=Children <br />Reason for Use: <br />Approval/Date: Facility Notified/Date: <br />Reservation Fee <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): i <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 group/organization. I/We agree to abide by and enforce <br />the rules and regulations of the City of Colton and certi that we have read the rules and regulations listed on the back of this application. <br />Signature of Applicant: Date: 9-2400"--O <br />11 <br />For Office Use Onl <br />1�:- " <br />04 <br />_ <br />Dte�e��iu"ttal�� <br />Payment Due Date <br />Ru <br />yy�,shit.{. <br />`�S°' . , <br />Approval/Date: Facility Notified/Date: <br />Reservation Fee <br />3= `� NIV ~°1 <br />SecurityRequired <br />Cleaning Deposit <br />Insurance Required i..� ��<� <br />Date Applicant Notified <br />- <br />Receipt Number <br />14 <br />Copies° <br />- <br />Staff Initials/Date <br />Remarks: <br />White: Office Yellow: Facility . Green: Maintenance Pink: Patron <br />PA, <br />