Office of Special Events Application for Use of College Facilities
6201 Winnetka Avenue
Woodland Hills, CA 91371
Tel: 818-719-6446 Event Date:
Fax: 818-610-6508
Today’s Date:
**NOTE: For multiple dates, please
attach a separate list to this application.
Time of Event:
Name of Event:
Setup Time: __________
Takedown Time: _________
Organization:
Day of Week:
Requestor:
# of Participants: ________
Spectators: ________
Vehicles: ________
Address:
Sponsor’s Name (ASO only)
Type of Organization:
Phone:
Fax:
Email:
Event Description:
Facility Requested:
Have you been here before? Yes No If no, complete attached vendor form (highlighted areas only)
Are you charging admission? Yes: No: If yes, how much:
Will you be serving food? Yes No
PAYMENT IN FULL IS REQUIRED AT TIME OF PERMIT ISSUANCE
Internal Use Only:
A Certificate of Insurance and an accompanying endorsement that includes the following is required: General Liability Comprehensive or
Commercial Form, minimum limits each occurrence $1,000,000, General Aggregate $2,000,000. Certificate must list Pierce College and Los Angeles
Community College as additionally insured. A copy of insurance must be submitted with this application.
DISCLAIMER: In submitting this Application, User agrees to indemnify, defend, and save harmless the Los Angeles Community College District
and Pierce College, its officers, employees and agents, from any and all loss, expense, fines, suits, proceedings, claims, damages, actions and
judgments of any nature whatsoever arising out of our in any way connected with occupancy, use of control of said demised premises by User, its
employees, members or participants.
Print
E-mail to: Solarlm@piercecollege.edu
The college requires a minimum of three business days notice of cancellation for a full refund.