Community Promotional Fund Application
APPLICANT INFORMATION:
Name of applicant: _Is __ aac =__ P __ a__ d __ ill __ a _____________________ _ Name of organization or group represented: Relay For Life, American Cancer Society Mailing address:
Contact phone number(s): Email Address:
Non-Profit?{R] YesONo If no, are you partnering with a non-profit: ____ _ PROJECT DESCRIPTION:
Name of Event: Relay For Life of Barstow
Amount requested: $_
2_,s_oo _____ _
What will the funds be used for and/or what are the waiver of fees for? The fundsfwajygr will bf u§fd to help brio� backlhgs1 Rebx For Life tg Jhs Pix 0{ l}ar;stow, we woukl Uke to utilize the Sports Park, a stage, and anything else that me be required to be at the specific location.
When will the activity take place? Saturday, May 2nd, or May 9th, 2026 Where will the activity take place? _.... s po_ _rt_s _Pa_rk _..... (p._av__ili_o_n_o_r _fle_ld __ )__________ _ Why are the funds/waiver of fees/in-kind services needed? Relay For Life, ACS, is a S01(c)3 charity; all money raised with/through this event are used to help in the fight against cancer. We are a big believer in being good stewards of the donar dollar.
How many Barstow area residents are involved with this organization? Approximately 300 How many spectators will watch this activity? Approximatelv 300-soo+ Please describe how this activity will benefit Barstow. If additional space is necessary, please attach additional sheets:
Relay for We: firs1 came to Bars.tow in 1999. and l,ms:4 umU 2021 (CQ}!]D) raising appwxima!ely $2 million 1n help in the fight against cancer. We're able to spread more awareness, provide more assistance, and let our fellow citizens affected by cancer know they are not alone in their battle. Previously we had a plethora of students from BUSD participate, allowing them to learn how to reach out to businesses, talk with peers/others, and teach them life skills to help them grow into adults. This event has proven to be one that many people wrap there arms around because the cause means so much to so many. Cancer affects so many people, 58th m and out of our community. Lets show the world once again that we are the small town with the big heart Rev. April 2020 Community Promotional Fund Application
Community Promotional Fund Application
With this application, please attach the following:
1. A detailed budget stating the total cost of the activity or event, all sources and amounts of funding, and all expenses;
2. A description of the organization's or group's purpose or objective.
3. A copy of the organization's non-profit determination.
By signing below, I declare that I have read the City's Community Promotional Fund Policy and agree to all Its terms and conditions. I agree that there Is a formal process In place to conduct background checks on all employees and volunteers who work with persons under the age of 18 years and senior citizens.
I understand that an incomplete application wlll not be accepted and that the organization or applicant will not be considered for funding. (If the application is being sub · ed on behalf of an organization or school, an additional signature is required.)
Si
School Principal or Organization
President/Director Signature
(if applicable)
Isaac Padilla, September 15, 2025
Applicant Name (printed) & Date
Rev. April 2020 Community Promotional Fund Application Pa1�2 Detailed Budget
• TUP Application Fee (non-profit): $42
• Inspection Fee (Friday – Sunday event): $181.10
• Sports Park Rental Fee: $1,000
• Stage Rental: $300
• Fees associated with cost of utilities: Unknown
• Fees associated with cost of city employees: Unknown
**This event/fundraiser heavily relies on sponsorship and the donation of those within our community and surrounding communities.
Organization Purpose/Objective
The mission of the American Cancer Society is to improve the lives of people with cancer and their families through advocacy, research, and patient support.