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Applicant Information (all fields are required) NAME OF APPLICANT ORGANIZATION (if applicable) APPLICANT ADDRESS CITY STATE ZIP+4 ORGANIZATION ADDRESS (if applicable) CITY STATE ZIP+4 CONTACT PHONE - home work cell CONTACT EMAIL DATE(S) OF REQUESTED RESERVATION TOTAL # OF PEOPLE (>100 requires a Special Event Permit) START AND END TIME OF REQUESTED RESERVATION TOTAL # HOURS DESCRIBE THE ACTIVITY OR EVENT FOR WHICH THE RESERVATION IS REQUESTED TOWN USE ONLY: TOTAL FEE REQUIRED Please Attach the Following Documents Certificate of Insurance (if required) Signed Use of Town Recreational Facility/Sports Field Release of Liability and Indemnification Agreement (For Sports Team Reservations - Parents of all minors participating need to sign and date the last page of the Agreement) APPLICANT’S SIGNATURE PRINTED NAME DATE FOR TOWN USE ONLY Park/Facilities Requested: (check 1) Dirty Woman Creek Park (304 Mitchell Ave.) Pavilion (and grills on the north side of the pavilion) Sports Field (bring your own sports equipment) Santa Fe Trail Baseball Fields (99 Santa Fe Ave.) North Field South Field Park Reservation Fees/Deposits: $50 Use Fee for the First 4 Hours – Plus $15 Per Each Additional Hour $35 Non-Refundable Maintenance Fee Per Date Requested $100 Refundable Damage Deposit DATE RECEIVED: Fee received: CHECK CREDIT CARD CASH Deposit rec’d: CHECK CREDIT CARD CASH RECEIVED BY DATE APPROVED: APPROVED BY: Town of Monument Park Reservation Application 645 Beacon Lite Rd., Monument CO 80132 [PHONE REDACTED] www.townofmonument.org