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APPLICATION FOR LIONS PARK CENTER FACILITY USE <br /> <br />Applications are to be submitted to Elk River Recreation, I104 Lions Park Drive NW at least 14 days prior to the first date requested ha <br />order to allow processing time. Some requests may require additional time for review, ffma~g ~.parcadon as a non-pmfltgro~,,pkase sxpp~ <br />proof af ~tatu~ udth app"cation. Please ma/em chec~'.rpqyabk ta the City af EI~ Paver. g~oaitr over $100 mu~ be made ~ cerfffied chec,~, money order or ~reda't <br />card. <br /> <br /> PLEASE CHECK DESIRED SPACES <br /> <br />Lions Park Center Spaces <br /> <br /> Meeting Room Main Kitchen <br />.... Attached Shelter with Interior Bathmom~ <br />Additional Spaces Available at Lions Park - See Park Use form for policies and fees <br /> <br />.. Bandshell ~ Shelter #1 <br />~ Ball Field ~ Shelter #2 <br />~ Park <br /> <br />Se~ring Kitchen - no appliances <br />Attached Shelter <br /> <br />Shelter #3 <br />Shelter #4 <br /> <br />PLEASE COMPLETE THE FOLLOWING <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 Acdv/ty <br /> <br />Start Time (including set up) <br /> <br />Will alcohol be present (please circle one) Yes No <br /> <br />City State Zip <br /> <br /> Ems.il Address <br /> <br /> Number of People Expected <br /> 0End Time (including take down and clean up) <br /> <br />If yes, beginning at and ending at <br /> <br />5 ' Round Tables Lectern PoLice Coverage <br />30" x 6' Rectangular Tables Portable PA System Building Supervision <br />Chairs Overhead Projector/Screen laasurance Policy <br />Coffee Pots TV/VCR Other <br />Extensions Cords Electridty in Shelter Other <br /> <br />ITEMS NEEDED FOR RENTAL--PLEASE COMPLETE WITH FACILITY COORDINATON <br />By signing this application, I acknowledge receipt of md agree to follow the Lions Park Facility Use Policy. I understand that a portion or <br />aB 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 cleaning needs required from my use of this facility. I <br />urtdersmnd I w/ll be the first one in the bu/lding and the last one to leave from my group md I must be present dm4.g the entire event. <br /> <br />Date and Tn'ne Received <br /> <br />Fees Paid <br /> <br />Deposit P~d <br /> <br />Copy of ~nsucance Policy, Received <br />Proof of 501 (c)3 Status Received <br /> <br />Planrmag Department Notified for Commission Review <br /> <br />Park and Recreation Commission Approval Received <br />Parks and Streets Department Notified " <br /> <br />Police Department Notified . <br /> <br />Permit Number <br /> <br /> <br />