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APPLICATION FOR FACILITY USE <br /> <br />Applications are to be submitted to Elk River Recreation, 1104 Lions Park Drive NW at least 14 days prior to the first date requested. In <br />order to allow time to process requests with special staff needs. Some requests may require review by the Park and Recreation <br />Commission. If making app,'cation as a non-profit group, pkase supp~y proof of status with application. P/ease make checks payable to the City of Elk l~a'ver. <br />Dq)o~its over $I00 must be made ~y certified check, money order or credit car~ <br /> <br />PLEASE CHECK DESIRED SPACES <br /> <br />Lions Park Center <br />Large Meeting Room <br />Lions Park Center <br />Kitchen <br />Lions Park Center Small <br />Conference Room <br /> <br />__ Main Shelter w/access <br /> to the inside bathrooms <br />__ Main Shelter (adjacent <br /> to Lions Park Center) <br /> Bandshell <br /> <br />Shelter # 1 <br />Shelter #2 <br />Shelter #3 <br />Shelter #4 <br />Ball Field <br />Park <br /> <br />PLEASE COI~IPLETE THE FOLLOWING <br /> <br />Renter/Organization Name <br /> <br />Address <br /> <br /> Street <br /> <br />Organization Contact Name, if applicable <br /> <br />Phone Work Phone <br />Activity <br /> <br />Date(s) of Activity <br />Start Time End Time <br /> <br />Will alcohol be served (please circle one) Yes <br /> <br />City State Zip <br /> <br />Email Address <br /> <br />Set Up Time Needed <br /> <br /> No If yes, beginning at <br /> <br />Fax <br /> <br />Number of People Expected <br /> <br /> Clean Up Time Needed <br /> and ending at <br /> <br />ITEI~IS NEEDED FOR RENTAL--PLEASE COI~IPLETE WITH FACILITY COORDINATOR <br /> <br />5 ' Round Tables Lectem Other <br />30" x 6' Retangular Tables Portable PA System Other <br />Chairs Overhead Projector/Screen Other <br />Coffee Pots Keys/Keycard Other <br />Extensions Cords Other Other <br /> <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 <br />all of my deposit may not be returned if these policies are not followed. I authorize the City of Elk River to file a claim against my <br />insurance company if the deposit I have given does not cover any damages or deanmg needs required from my use of this facility. I <br />understand I will be the first one in the building and the last one to leave. I am the only one who will have access to the keys I have been <br />assigned. <br />Signature Date <br /> <br />FOR OFFICE USE ONLY <br />i Date and Time Received Planning Department Notified for Commission Review <br />Fees Paid Park and Recreation Commission Approval Received <br />Deposit Paid Parks and Streets Department Notified <br />Copy of Insurance Policy Received Police Department Notified <br />Proof of Non Profit Status Received Permit Number <br /> <br /> <br />