� � �,,-.[ '/1.J Application for Use of Indoor City Facilities icv /Ill,
(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# ____ _
A valid picture
City_ ... ----'-----'------'-------
I.D. is required at the time of application
Zip Code---
to verify age and/or residency.
Proof of Signal Hill Residency (if applicable): DDriver's License DCurrent Utility Bill DEmployed 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: J4F { fo) Refundable damage deposit will be mailed to the address provided 6 to 8 weeks after your event Description of Event: Bl-mon711 Y ' FtJ 51-!l- fYJGm /3E� fill; P fY7tEV;J6 5' IN ;){)� If Event time should reflect setu� and cleanup. Please allow a minimum of one hour for cleanup.
Event Date: ,J.;J'/) /fr I U[5 Event Day:
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Rental Start time: /_L , 7 , lf J Rental End time: _lP __ _ 1 ; lf 5
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Space Requested @: 1 UE'S fYJ.IJ 'I J � 70 [5" JZ;tyq/ 7U£5' s;; P1 JO I Ju£, )J.. (VD ll Community Centers rJo�tf
D Discovery Well Park Community Center (standard room set up 6 round tables and 36 chairs diagram) Only 36 seating max D
Will food be served? Yes No (no red food/drink)
Will event be professionally catered? LI Yes I No If yes, name of catering company _________ _ Will the event include musical entertainment? Yes No If yes, what type? Band DJ Radio Bluetooth Speaker Signal Hill Park Community Center (attach room set up diagram) Capacity: 100 Available Rental Times: 8:00am-10�00pm Monday, Tuesday, Wednesday, Thursday/ 8:00am-10:00pm Friday, Saturday, & Sunday Will food be served? Yes No (no red food/drink)
Will event be professionally catered? Yes No If yes, name of catering company----------- Will the event include musical entertainment? Yes No If yes, what type? Band DJ Radio Bluetooth Speaker ***Room & carpet condition has been viewed INITIALS:. __ _ Library Facilities
D Library Community Room (attach room set up diagram) Capacity: 48-70 (depending on room set-up) Available Rental Times: 8:00am-1 O:OOpm Monday, Tuesday, Wednesday, Thursday/ 8:00am-11 :OOpm Friday, Saturday, Sunday Will food be served? Yes No (no red food/drink)
Will event be professionally catered? Yes No If yes, name of catering company __________ _ • Small serving kitchen included
Will the event include musical entertainment? Yes No If yes, what type? Band DJ Radio Bluetooth Speaker D Library Zinnia Courtyard Capacity: 54
Only available when the library is closed.
Available Rental Times: 5:00pm-10:00pm Wednesday, Friday, Saturday/ 8:00am-10:00pm Sunday Will food be served? Yes No (no red food/drink)
Will event be professionally catered? Yes No If yes, name of catering company ----------->:11 Will the event include musical entertainment? Yes No If yes, what type? Band DJ Radio Bluetooth Speaker Attachment A