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APPLICATION FOR LIONS PARK CENTER FACILITY USE <br />~~t. ~, <br />~+ ~ Applications are to be submitted to 81k River Parks and Recreation, 1104 Lions Park Drive NW at least 14 days prior to <br />ver the Erst date requested in order to allow processing time. Some requests may require additional time for review. Irnmk>rog <br />Parks and applirolioa or a non /irojrtgroup, please supply proojojrla7ur u~i1G appL'rafron. Pdeate wake tl~erk.r payobk to Ilse City ojFak Raver. <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 Shelter #1 Shelter #3 <br />Ball Field Shelter #2 Shelter #4 <br />Park <br />PLEASE COMPLETE THE FOLLOWING <br />Renter/Organization Name <br />Address <br />Street <br />City <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 />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 6' Rectangular Tables TV/VCR/DVD Building Supervision <br />Chairs Insurance Policy <br />By signing this application, I acknowledge receipt of and agree to follow the Lions Park Facility Use Policy. I understand that a portion or all <br />of my deposit may not be returned if these policies axe not followed. [authorize the City of Elk River to file a claim against my insurance <br />company if the deposit I have given does not cover anti damages or leaning needs required from my use of this facilih'~ I understand 1 will be <br />the first one in the building and the last one to leave from mt~ group and I must be present during the entire event. <br />Signature <br />Date <br />FOR OFFICE USE ONLY <br />Date and Time Received Planning Department Notified for Commission Review <br />Fees Paid Parks and Recreation Commission Approval Received <br />llcposit Paid Streets Dcpartmcnt Notified <br />Copp of Insuranm Poliq~ Received Police Department Notified <br />Proof o(501(e)3 Status Received Permit Number <br />Work Phone <br />Fax <br />State Zip <br />Email Address <br />Number of People Expected <br />End Time (including take down and clean up) <br />