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APPLICATION FOR LIONS PARK CENTER FACILITY USE <br />El ~~ Applications are to be submitted to F.lk River Parks and Recreation, 1104 Lions Park Drive NW at least 14 days prior to <br />River the first date requested in order to allow processing dme. Some requests may require additional time for reeriew. If making <br />Parks and application ar a non profit,groxp, pdeare ripply proof of rtatur with application. Please make checks payable to the City of Elk River. <br />Recreation <br />PLEASE CHECK DESIRED SPACES <br />Meeting Room <br />Kitchen <br />Additional Spaces Available at Lions Park -See Park Use form for policies and fees <br />Bandshell <br />Ball Field <br />Park <br />Shelter #1 <br />Shelter #2 <br />PLEASE COMPLETE THE FOLLOWING <br />Renter/Organization Name <br />Address <br />Street <br />Organization Contact Name, if applicable <br />Phone <br />Activity <br />Date(s) of Activity <br />Start Time (including set up) <br />Will alcohol be present (please circle one) Yes No <br />Fax <br />Shelter #3 <br />Shelter #4 <br />State Zip <br />Number of People Expected <br />End Time (including take down and clean up) _ <br />If yes, beginning at and ending at _ <br />ITEMS NEEDED FOR RENTAL-PLEASE COMPLETE WITH FACILITY COORDINATON <br />5' Round Tables Lectern Police Coverage <br />30" x G Rectangular Tables TV/VCR/DVD Building Supervision <br />Chairs Insurance Polity <br />By signing this application, I acknowledge receipt of and agree to follow the Lions Park Facility Use Policy. 1 understand that a portion or all <br />of my deposit may not be returned if these policies are not followed. I authorize the City of F,lk River to file a claim against my insurance <br />company if the deposit I have given does not cover any damages or cleaning needs required from my use of this facility. I understand I will be <br />the first one in the building and the last one to leave from my group and I must be present during the entire event. <br />Signature <br />Date <br />Date and Time Received Planning Department Notified for Commission Review <br />Fees Paid Parks and Recreation (:ommission Approval Received <br />Deposit Paid Streets Department Notified <br />Copy of Tnsurance Policy Received Police Department Notified <br />Proof of 501(c).3 Status Received Permit Number <br />Email Address <br />Work Phone <br />City <br />