EL MONTE PARKS, RECREATION AND COMMUNITY SERVICES DEPARTMENT
AGREEMENT AND APPLICATION FOR FACILITY USE
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Please complete the following application, read the rules on the back page, and sign agreement.
1. EVENT DATE(S) REQUESTED: ____________________________ ACTUAL TIME OF EVENT:
____________________
ACTIVITY TIME NEEDED (Include set up time): ________________________________________________________
___
2. FACILITY LOCATION: ____________________________________________ ROOM(S):
________________________
3. PURPOSE OR NATURE OF USE: ________________________________________________________________________
4. WILL THERE BE ENTERTAINMENT? YES NO WILL ALCOHOL BE SERVED/SOLD? YES NO
Only El Monte Nonprofit Groups are eligible to sell alcohol. Other groups and private parties may serve wine,
beer and champagne with restrictions. In order to obtain approval to serve alcohol, an Alcohol Use permit must
be submitted a minimum of
8 weeks in advance along with this application.
5. Total Attendance ______ (Max. dining capacity for CC Aud. is 300) Adults______ Children________
6.
REQUESTING KITCHEN USE REQUESTING KITCHEN SUPERVISOR TIME: ___________________
A Kitchen Supervisor is required at any event where kitchen supplies or equipment will be used. Kitchen supervisor fees
will be included in the facility use confirmation. Will a caterer be cooking outside (Grill/BBQ)? YES NO $200 cleaning deposit is required.
7. REVENUE:
.
ADMISSION CHARGE: Yes
No AMOUNT PER PERSON _______
8. ROOM PREPARATION / DECORATION: Please note that decorations require prior approval. Crepe paper cannot be
used in facility. Signs or decorations are not to be taped, nailed or otherwise attached to walls, windows, ceilings, or drapes.)
ADDITIONAL REHEARSAL/ PREPARATION: Day and time: ___________________________________________
9. EQUIPMENT NEEDED: P.A. System/Podium Stage Number of Chairs ______ Number of Tables ______
Please Note: The buildings do not have Wi-Fi. All tables used to serve food must be covered with tablecloths. You must
receive prior approval to bring outside equipment such as (lights, photo booth, etc.).
A USE FEE WILL BE CHARGED FOR THE FOLLOWING:
Projector & Screen Coffee Pot(s) 50-cup 100-cup Bar Patio for seating /serving food
*Stage performances will include ______________________________________________________________________
HOLD HARMLESS AGREEMENT
I hereby certify that I have carefully read and will abide by the rules and regulations as well as all other City Ordinances
printed on the back of this application, and in signing this application, I hereby agree that I, and the organization I represent,
shall hold the City of El Monte and its agents and employees free and harmless from any liability or damage which may arise
from our use of City facilities. I further agree to promptly reimburse the City of El Monte for any cleanup, loss or damage to
City property resulting from this use.
10. NAME OF GROUP, ORGANIZATION OR INDIVIDUAL USING FACILITY: ________________________________________
NON PROFIT I.D. #__________________________________ (Non Profit groups, please attach determination letter from the IRS/FSTB)
Will this event be opened to the public? YES NO
AUTHORIZED ADULT REPRESENTATIVE: _____________________________________ TITLE: ____________________
ADDRESS ___________________________________________________ HOME/WORK PHONE: __________________
CELL PHONE: ___________________
EMAIL : _____________________________________________________________
SIGNATURE:
_________________________________________________________ DATE: ________________________
Application must be submitted to the Parks and Recreation Office in order to be reviewed. Div. Mgr. Approval____________
* * * * * * * * * * * * * * * * * * ** * * * * * * * * * * *
OFFICE USE ONLY * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * *
RENTAL:
SCHEDULE NO. __________
(1)
CC Sm. Aud. …………........……$ _________
(6)
Bar serving charge …................….. $ _______
(12)
Log Cabin ………..........……….... $ _______
(2)
CC Lg. Aud. ……………........…$ _________
(13)
Gymnasium Use ……….......... $ _______
(2)
CC Room #____ ……..........$ _________
(14)
Sr. Ctr. Room #_____…..... $ _______
(3)
Park Site……………..…….......... $ _________
(7) Off-hour coverage ___@____ $ _______
(8) Full-Time Maintenance coverage
_______ hrs. @ $ _______/hr......... $ _______
(15)
Pool Rental …………….............. $ _______
(4)
Kitchen use/supervisor…$_________
(9)
Cleaning Fee ….......................…………$ _______
(16) Aquatic Room #______...$ _______
(5)
Equipment …………….…..........$_________
(10)
Field Prep /Use …….....................…$ _______
(17)
Special Facility Use…........ $ _______
(Coffee pots, projectors, bases, etc.)
(11)
Energy/Light Use …......................…$ _______
TOTAL FEE $_______________
Payment deposited in Acct. # ______________
Special Requirements (X)
ABC Permit
Rental Deposit _______
Non Profit I.D.
Insurance Certificate Room(s) Set-up
By: ___________ By: _______________ By: _________ By: ____________ By: ____________
Security Required - Separate fee will be assessed
Additional fees
3130 N. Tyler Avenue, El Monte, CA 91731 | Phone: (626) 580-2200 | FAX: (626) 580-2237
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