Park Use and Special Event Permit Policy and Application 201 West Sierra Avenue, Cotati CA 94931(707) 792-4600
Name of Applicant or Organization: Sophia Costa/The Yard Markets Sophia Costa ID # (if Non-Profit):
Name of Contact:
655 Enterprise Dr Apt 2 Rohnert Park, CA 94928
Address:
Street City State Zip Code
4083904245 [email protected]
Phone Number: Email Address:
9/9 8am-5pm 500
Date of Event: Arrival/Completion Time: Estimated Attendees:
Small Business Market
Type of Special Event:
PARK REQUESTED:
La Plaza Park Kotate Park Sunflower Park
Draper Park Falletti Park Santero Park
Putnam Park Veterans Park Civic Center (Cator) Park
Alcoholic Beverages Sold: Yes Food served: Yes Sold
Street Closure Requested: Yes No Park Closure Requested: Yes No Animals: _ Dogs Allowed Electricity Needed: Yes No
Inflatable Jump House: Yes Film Production: (if yes, see pg. 10) Yes No As an applicant for a City of Cotati Park Use and Special Event permit, facilities, I hereby agree to assume all risks for loss, damage, liability, injury, cost or any expense that may arise during or be caused in any way by use or occupancy of any area or facility of the City of Cotati. I further agree that in consideration of being permitted to use said facility, I will hold the City of Cotati, its officials and employees free and harmless from any loss, liabilities, damages, and/or injuries to persons and property occurring during applicant's use or public liability insurance as stated in "Park Use and Special Event Permit Policy" with the City of Cotati named as additional insured to be submitted no later than one month prior to the rental date. I have read the rules and regulations of rental carefully and agree to them as written. I understand that applications not submitted thirty (30) days prior to event may not be able to be processed.
I, the undersigned, acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that myself and others attending my event may be exposed to or infected by COVID-19. I agree to having all attendees follow CDC and Sonoma County Department of Public Health recommendations for enhanced health and safety measures related to COVID-19 and follow all posted instructions while using City facilities; including requirements for social distancing, wearing of face coverings, participant grouping, types of activities allowed, and potential limits on event size.
Sophia Costa 06/06/2023
Applicant Signature: Date:
Date of Application: Date Insurance Received:
Additional Comments/Conditions:
$400
Park Use Fee Deposit Received: Deposit Returned:
101-00-60702-000000 101-00-35002-000000
$702 N/A
Street Closure Fee: Restroom Cleaning Fee:
101-23-64022-000000 101-24-80188-CLEANS
Group Classification: Cotati Resident
No Rite DABC License Received A