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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 FacilityOther <br />RequestedFacility(s): -"t LA t_�i7E7V14 rr11 <br />Requested Date(s) (Day/Date): -r <br />Set -Up Time: ((� bto ( fK Program Time: I to Clean -Up Time: 9 to 10 <br />Group/Organization: Utj tT <br />E <br />I N tS T <br />(O' LO Children <br />Contact Person:AT- <br />C6066KT <br />Alternate Contact Person: 5K.100 <br />OV -7, <br />Address: l o e, <br />Address: �7(m w. O 9T <br />City & Zip Code: &tW 6 . <br />0(21�bc4 <br />City & Zip Code: 6,.jbJCA- <br />q2324 <br />Home Phone: W2-7112_ <br />Work Phone: <br />Z(o (— Gc t 7 <br />Home Phone: qZDr p ( I I <br />I Work Phone: <br />R5.?— <br />Estimated Total Event Attendance: <br />' Adults <br />�'SO Teens <br />(O' LO Children <br />Reason for Use: CO -I fAey( <br />C6066KT <br />Equipment/Services Requested: # of Tables _ Athletic Lights _ Field Preparation <br />(subject to availability) _ # of Chairs times: from: pm _ Bases <br />Kitchen/Concessions n to: pm _ P.A. System <br />✓dditionalRequest(s): P.C>Teooms PhWiiZ F PWS <br />RENTAL AGREEMENT P I1'� FA'eX <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 faci ' ' s 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 oton and fy at we have read the rules and regulations listed on the back of this application. <br />Signature of Applicant: Date: ZS <br />Approval/Date: <br />Security Required <br />Insurance Required <br />Copies <br />Remarks: <br />Facility Notified/Date: <br />Payment Due Date <br />Reservation Fee <br />Cleaning Deposit <br />Date Applicant Notified <br />Receipt Number <br />Staff Initials/Date <br />White: Office Yellow: Facility Green: Maintenance Pink: Patron <br />