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RECREATION DEPARTMENT 7007 MOESER LANE EL CERRITO, CA 94530 (510) 559-7004 Fax (510) 528-9413 FIELD RENTAL APPLICATION APPLICANT NAME APPOINTED REPRESENTATIVE RENTAL DATE(S) ORGANIZATION NAME FIELD REQUESTED RESTROOM KEY YES NO STREET ADDRESS TIME FROM TO CITY ZIP (TIME INCLUDES PREPARATIONS AND CLEAN-UP) APPLICANT HOME# APPLICANT WORK/CELL # APPOINTED REP. HOME# APPOINTED REP. WORK/CELL # DRIVER’S LICENSE # TYPE OF ACTIVITY # OF PERSONS EXPECTED OFFICE USE ONLY DEPOSIT RECV’D CHECK # TOTAL AMOUNT DUE ---PAGE BREAK--- RECREATION DEPARTMENT 7007 MOESER LANE EL CERRITO, CA 94530 (510) 559-7004 Fax (510) 528-9413 DATE STAFF INITIALS AMOUNT PAID RECORDED IN BOOK?YES NO DATE CONFIRMATION SENT APPLICATION APPROVED? YES NO RENTAL COORDINATOR’S SIGNATURE SUPERVISOR/DIRECTOR SIGNATURE The holder of this permit has exclusive use of the field for the date and time listed above. Special Permit Notes: RENTAL AGREEMENT 1. Applicant understands that this is an application only. Your application will be reviewed and confirmed or denied within ten working days based on the information provided on the reverse side of this document. Do NOT announce the date and the field until it is confirmed. 2. If the applicant wishes to cancel, a written cancellation form must be completed, and returned to the Field/Rental Coordinator. If the date is not re-rented, the fee will be forfeited. If the da te is re-rented by the City, a $25.00 cancelation fee will be charged Transfer of dates will only be permitted a minimum on one week in advance and requi res and an additional fee of $17 .00. 3. Applicant understands that 15 minutes after the end of the event must be reserved to allow for guest/applicant to remove all personal items and clean area. If the program or clean-up exceeds the stated time, or if set-up begins before the stated hour, the hourly rate is doubled for the unauthorized time. 4. Applicant understands that they, or an appointed representative, listed on front of application must be responsible for all communication and cancellation of field use. ---PAGE BREAK--- RECREATION DEPARTMENT 7007 MOESER LANE EL CERRITO, CA 94530 (510) 559-7004 Fax (510) 528-9413 5. Applicant understands that alcohol is not allowed on any City of El Cerrito facility or field. 6. Applicants who wish to change any of the pre-agreement will be charged $17.00 changing fee for each item changed. 7. Rest Room keys may be purchased for $17.00 from the El Cerrito Recreation Dept. I hereby release and hold harmless the City of El Cerrito, its officers, employees, and volunteers from liability for damages, cost and expenses which may incur as a result of property damage or personal injury in connection with renting the above facility. I have read and understand the responsibilities of an applicant renting the City of El Cerrito facilities Applicant Signature Date