Fillable SPECIAL PARK EVENT APPLICATION PO Box 458 * (City of Veneta)

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SPECIAL PARK EVENT APPLICATION PO Box 458 * (City of Veneta)

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Country of origin: US
File type: PDF

U.S.A. forms for City of Veneta

BROWSE CITY OF VENETA (OR) FORMS

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S:\FORMS\Parks & Recreaon
Name of Organizaon/Applicant: ___________________________________________________________________
Mailing Address: _______________________________________________ City/Zip: ________________________
Phone (s): __________________________________________ Email: _____________________________________
Esmated aendance: ___________________
Type of Event ___________________________________________________________________________________
Purpose for which facility is to be used _________________________________________________ _________ ___
________________________________________________________________________________________ ____ __
Park Requested _________ __________ ___________________
Other Equipment Requested _________________________________________________________________________________
Specify Dates
Starts _________ _______ to ______________________ ______ am/pm to
_______ am/pm
Specify Weekly, monthly, et. ________________________
Supervisor in charge of acvity ______________________________________________________________________
(name and contact informaon)
I cerfy that I am the authorized representave of the above group( s), and that the above statements are true to the best of my
knowledge.
A Certificate of Liability Insurance must be provided prior to the use of the facility naming the City of Veneta
as an additional insured.
________________________________________________________ __________________________
Signature of Applicant Date
City Administrator or Designee Approval _______________________________________ Date ____________________
PO Box 458 * Veneta, OR 97487 * 541-935-2191 * Fax 541-935-1838 * www.venetaoregon.gov
SPECIAL PARK EVENT
APPLICATION
Proof of Insurance Provided
YES NO
Room Arrangement Discussed
YES NO
Date is Available YES NO Building Sta Assigned YES NO
Equipment Available YES NO
For Ocial Use Only
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SPECIAL PARK EVENT APPLICATION PO Box 458 * (City of Veneta)

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Completed 17 July 2020

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