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Ad.ess: <br /> <br />Representing Organization <br /> <br /> CITY OF RAMSEY <br />PARK FACILrFY USE PERMrT <br /> <br />Central Park <br />(specify ama) <br />other <br /> <br />Titter'ad Park <br />(specify area) <br />Park Center Building <br /> <br />Phone (~): <br /> <br />(lq): <br /> <br />has permission to use <br /> <br /> facilities on <br /> <br />(date) <br />and <br /> <br />for the purpose of <br /> <br />between the hours of <br /> <br />Special Arrangements: <br /> <br />Fees: $5.00 per day building use <br /> $15.00 key deposit <br /> <br />$200.00 field deposit <br /> <br />Receipt no.: <br /> <br />Receipt no.: <br /> <br />Key returned on: <br /> <br />Receipt no.: <br /> <br />t'[ey DO.: <br /> <br /> Init/als: <br /> <br />Hours of Use: 7:00 a.m. to 10:30 p.m. <br /> <br />THE USE OF THESE FACE..,1TIES REPRESENTS .4. pRIv_rl _W. GE ANrD MAY BE REVOKED <br />AT ANrY TIB,~ WITH OR WITHOUT PRIOR NOTICE BY THE CITY COUNCIL OR CITY <br />ADMD¥ISTRATOR. <br /> <br />I, the undersigned, have read and understand the Prior/des of Use and Rules of Use listed on thc <br />reverse side of this application. I understand that a :4oiarion of these rules max, result in forfeiture <br />of an>, deposits and additional liability for damages. I also understand that'I am responsible to <br />report an3, vandalism or abuse to the Ramsey Police Department. It is a~eed by the parties hereto <br />that those inchviduals included in the above ~oup will hold the City of Rmmsey hm-miess for an>, <br />damages or personal injuD' incurred as a result of the use of this facihB, by those individuals. <br /> <br />User Signature: <br /> <br />CITY OF RAMSEY: <br /> <br />Date: By: <br /> <br />FOR CITY USE ONLY: <br /> <br />Pm-k Inspected By: <br /> <br />Dater <br /> <br />Full Refund: <br /> <br />Pm-rial Refund: <br /> <br />Comments: <br /> <br />Cop), of permit to: User, Administrative Sen'ices, Finance Office <br /> <br /> <br />