Application For Use of Outdoor City Facilities
Park Picnic Shelters
(APPLICATION MUST BE SUBMITTED IN PERSON)
Submission of application does not guarantee a reservation until approval by the Community Services Director or his/her designee.
Address Unit#
city SI (?AIAv 11-JU/
Phone numbers: Cell Email
A valid picture 1.0. is required at the time of application to verify age and/or residency.
Proof of Signal Hill Residency (if applicable): □Driver's License □Current Utility Bill □Employed in Signal Hill I certify that I am a resident of Signal Hill and that I will be onsite at the event for the entire duration of the event. I understand that if I am found to be renting the facility for a non-resident, the non-resident fees will be deducted from my deposit. - Initials: (1.F
Refundable damage deposit will be mailed to the address you provide 6 to 8 weeks after event Description of Event: F 8 L-l- PJo 01< s It i E
Event day: 1t/ UJZ'5 V fl'/ Event time should reflect setup and cleanup.
Event date: 0 C 1 /:) Start time: / 6 ft m End time: SP fJll Picnic Shelter rental must be made in increments of 4 hours 131/E.rrt. '� /\IooN - if Prn Choose a Park@':
D Discovery Well Park (Residents Only) (25 capacity)
D Picnic Shelter #1 or #2 (circle one) D Jumper □ Amphitheatre *REQUIRES PARKS AND RECREATION C0MMMISSI0N APPROVAL 0 Signal Hill Park
D Picnic Shelter (circle one) (50 capacity) #1 or #3 D Jumper (choose from approved vendor list) (25 capacity) #4
□Amphitheatre O with electricity *REQUIRES PARKS AND RECREATION COMMMISSION APPROVAL 0 Open Space *REQUIRES PARKS AND RECREATION COMMMISSION APPROVAL D Reservoir Park
D Picnic Shelter (50 capacity) D Jumper (choose from approved vendor list) □ Open Space *REQUIRES PARKS AND RECREATION COMMMISSION APPROVAL D Hilltop Park (Adults only)
D Picnic Shelter #1 or #2 (circle one)
(25 capacity)
D Wedding Open Space (max of 75 people)
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J- [of lO) CANV'!r5 'Bf1tvtJ€R5 fiUN6 J-sSffll
Community Services Department • 1800 E. Hill Street Signal Hill CA 90755 • (562) 989-7330 /. i, PJMfZ'-/ ('-ifrll...}/'J� I F/tC/tJG /))t;.7'[
Rev1sed2-16-23
J, rf tU, St t 1fmPL� C6f<Ju'£/2- Attachment A