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APPLICATION FOR LIONS PARK CENTER FACILITY USE <br />~~ _ <br />Ve'r Applications are to be submitted to EII: River Parks and Recreatioq 1104 Lions Park Deive N\Xt at least 14 days prior to <br />the first date requested in order to allow processing time. Some requests map require additional time for review. f/gym,(=.J,f~ <br />~~ ~~ app/irotion aJ a noa prvfil g/rof p, p/rare ,rvpp/y progjojJlatur ll'f1/1 Opp/flOhOq. IJ/epJP A/OkP f{Xf~,f /JO)~aG& to tGe Ci7)~ ojE/k R(eer. <br />Recrratipn <br />PLEASE CHECK DESIRED SPACES <br />Meeting Room <br />IGtchen <br />Additional Spaces Available at Lions Park -See Park Use form for policies and fees <br />Bandshell Shelter #1 <br />Ball Field Shelter #3 <br />Shelter #2 Shelter #4 <br />Park <br />PLEASE COMPLETE THE FOLLOWING <br />Renter/Organization Name <br />Address <br />Street <br />Organization Contact Name, if applicable <br />Phone Work 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 />City <br />Fax <br />Email Address <br />State <br />Number of People Expected <br />Zip <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 />S' Round Tables Lectern <br />Police Coverage <br />30" x G' Rectangular Tables TV/VCR/DVD <br />Building Supernision <br />Chairs <br />Insurance Policy <br />Bp signing this appGcatioq I acknondedge receipt of and agree to follow the Lions Park Facilit}' Use Policy. I understand that a portion or all <br />of my deposit map not be returned if these policies are not followed. I audtorize the Citg of L'll; River to file a claim against m}' insurance <br />company if the deposit I have given does not cover any damages or leaning needs reyuired 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 1 must be present during the entire event. <br />Signature <br />Date <br />FOR OFFICE USE <br />Date and Time Received <br />Fees Paid <br />Deposit Paid <br />Copp of Insurance Puliev Received <br />Proof of 501(c)3 Status Received <br />Plannin5 Department Nuti Fied (or Commission Review <br />Parls and Recreation Commission i\pproval Received <br />Streets Dcparnncnt Noti lied <br />Pnhcc llcpartmcnt Nnti(icd <br />Pcrmu Number <br />