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CITY OF COLTON <br />` HUMAN SERVICES DEPARTMENT <br />APPLICATION AND AGREEMENT FOR FACILITY USE <br />REQUEST FOR USE OF Fleming Park <br />ON (DATES) 8-30-90 <br />FACILITIES AND EQUIPMENT REQUESTED <br />❑- Multi -Use Room Ek Banquet Tables # i_ <br />Activity Room 11C Chairs # 100 <br />❑ Community Room ❑ P.A. System <br />❑ Kitchen ❑ Other <br />Baseball Diamond <br />L7 Pool <br />TIME OF USE <br />FROM 5:00 A.M., P.M. <br />TO 9:-00 A.M., P.M. <br />I. Purpose of Activity: to ann„int the new student <br />and their parents with the band program <br />2. Expected Attendance: Adults 75 <br />Youth 60 <br />3 Is Activity Open to the Public: <br />Yes _ No X <br />4. Will Admission Be Charged: <br />Yes No X <br />5. Will Donations Be Accepted: <br />Yes No X <br />If yes, what will the proceeds be used for? <br />Application For Facility Use Is: <br />Approved Denied <br />BY <br />Facility/Pool/Field/Park <br />(Circle One) <br />We hereby certify that we shall be personally responsible, on <br />behalf of our organization for any damage or unnecessary <br />abuse of buildings, grounds or equipment through the use <br />of said premises by our organization. <br />WE AGREE TO ABIDE BY AND ENFORCE THE RULES AND <br />REGULATIONS OF THE CITY OF COLTON AND CERTIFY <br />THAT WE HAVE READ THE RULES AND REGULATIONS ON <br />THE BACK OF THIS APPLICATION. <br />Name of Organization rot ton vel 1 ow jacket <br />Band Parents <br />Name (please print) Carol Johnson <br />Signature <br />Title President <br />Address 640 N Fourth St <br />S City, Zip Code Colton, Ca. 92324 <br />Phone (daytime) 876-4238 <br />Date 7-11— 1930 -- <br />FOR DEPARTMENT USE ONLY <br />Approval Is Subject To Conditions Listed On Back <br />Deposit <br />Remarks <br />Date Paid , 19_ <br />White - Office Date Processed '19 <br />Yellow - Permittee <br />Pink - Facility <br />Goldenrod - Public Works <br />