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v City of Colton <br />Parks, Recreation & Family Services Department <br />APP LI ATIUN F It FACILITY ER�'ATI N <br />Meetin Room ____ Athletic Field <br />A lication For: Banquet Hall ,.. <br />n �L <br />M <br />Requested Facility(s): <br />Requested Date(s) (Day/Dute): <br />Program Time: to <br />Set -Up Time. <br />Group/Organization: <br />Contact Person: <br />Address: 1� Q <br />City & Zip Code: <br />Home Phone:Yjb_� <br />acilit <br />uattcs F y <br />Clean -Up Time: <br />Alternate Contact Person: <br />�- Address: <br />)r <br />Z�Z q•- City & Zip Code: <br />5 Z Work Phone: L�"'�D �% 0 Home Phone: <br />Do. <br />aa""'M'o <br />Work Phone: <br />Estimated Total Event Attendance: bb Adults Teens Children <br />Reason !or Use: ��� �,�- (� � '� <br />Equipment/Services Requested: _ # of Tables Athletic Lights �__ Field Prrparation <br />(subject to availability) # of Chairs times: from: pm Bases <br />Kitchen/Concessions to: m P.A. S stem <br />Additional Request(s): <br />ZP <br />RENTAL AGREEWNT <br />I/We hereby certify that we shall be ersonally responsible, on behalf of our grouplorganization, for any damage or abuse of building° s, <br />grounds, fields, equipment, or*other- <br />s through the use of said premises by our grouplorganization. I/We agree to abide by anu enforce <br />the rules and regulations of thon and certify that we have read the rules and regulations listed on the back of this applicAtion. <br />Signature of A ilea Date: <br />8 PP <br />Daw Received"tiais: J '� ' <br />Approval/Date: Facility Notified/Date: <br />Security Required - Verified: <br />Payment Due Date <br />Reservation Fee <br />Cleaning Deposit <br />Insurance Required - Verified: <br />Date Applicant Notified- <br />otifiedReceipt <br />Copies <br />ReceiptNumber <br />- <br />Staff Initials/Date <br />Remarks: <br />White: Office Yellow: Facility Crreen: Maintenance Pink: Patron <br />