Fillable APPLICATION Rosehill Community Center 304 Lincoln Ave Mukilteo, (City of Mukilteo)

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APPLICATION Rosehill Community Center 304 Lincoln Ave Mukilteo, (City of Mukilteo)

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Rosehill Community Center
304 Lincoln Ave
Mukilteo, WA 98275
425-263-8180
PICNIC SHELTER RENTAL FAX 425-353-2457
recreation@mukilteowa.gov
APPLICATION
INSURANCE IS REQUIRED FOR ALL WEDDINGS OR WEDDING RECEPTIONS
*Parking Fees Apply*
Applicant Information
Applicant Name
Company/Organization
Mailing Address
City:
State:
Zip:
Phone
Day:
Evening:
E-mail
Event Information
Type of Event
Describe general nature of event (i.e. family outing, company picnic, etc.)
Event Date:
What hours will you use the shelter? The shelter is available: 8 am- 10 pm
Medium Shelter at Lighthouse Park - (Approx. 32 people sitting in covered area)
Full Day 8 am – 10 pm $100
Half Day 8am – 2pm $60
Half Day 4pm - 10pm $60
Large Shelter at Lighthouse Park – (Approx. 48 people sitting in covered area)
Full Day 8 am – 10 pm $120
Half Day 8am – 2pm $80
Half Day 4pm - 10pm $80
Other Facilities you plan to use (check all that apply):
Sand Volleyball Court ($15/hour) Time: __________ to ____________
Mukilteo Lighthouse Grounds (separate agreement with Historical Society)
Is this event
Private OR Public?
(Please select the checkbox after
reading the description to the
right.)
A private event is one in which you have a specific guest list and
know who is going to attend. A public event is open to the general
public through word-of-mouth, flyers, signs, or media advertising.
Will participants be charged a
fee?
Yes No
If Yes, please explain how much and purpose for collecting fee?
Attendance
Number of people expected?:
NOTE:
Groups of 100 or more must rent both shelters.
Groups of 100 or more a Special Event Application may be required.
Groups of 100 or more insurance is required.
Rosehill Community Center
304 Lincoln Ave
Mukilteo, WA 98275
425-263-8180
PICNIC SHELTER RENTAL FAX 425-353-2457
recreation@mukilteowa.gov
R:\Rental Packets\Picnic Shelter Rentals\Individual Documents\2020 01 Picnic Shelter Application.doc Page 2 of 2 Page 2 of 2
I have read and agree to comply with all Picnic Shelter Rental Guidelines including the refund policy.
Indemnification/Hold Harmless
User shall defend, indemnify and hold harmless the City, its officers, officials, employees and
volunteers from and against any and all claims, suits, actions, or liabilities for injury or death of any
person, or for loss of damage to property, which arises out of the use of Premises or from any
activity, work or thing done, permitted, or suffered by the User in or about the Premises, except only
such injury or damage as shall have been occasioned by the sole negligence of the City.
User Acknowledgement/Agreement
I hereby assume full responsibility for the facility’s use and agree to comply with all rules and
regulations of the City of Mukilteo. The information given in this application is said to be true under
the penalty of perjury by the Laws of the State of Washington and regulations of the City of
Mukilteo. I understand the City of Mukilteo reserves the right to deny use, change, or cancel any
part of this Picnic Shelter Application and any related scheduled activities.
Date:
Rental Approval (For City Use Only)
Approved by:_______________________________ Date: ________________________
Renter has received rules and guidelines. Date: ________________________
Reservations are made once application and payment are received.
Space cannot be reserved without payment.
Complete the application form and return it in person, by mail, FAX or email to
recreation@mukilteowa.gov. We accept the following forms of payment: cash, check, Visa, M/C, or
American Express.
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APPLICATION Rosehill Community Center 304 Lincoln Ave Mukilteo, (City of Mukilteo)

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Completed 14 July 2020

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