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McCullough Rodeo Arena Located inside Petrack Park 150 N Hwy 160 Pahrump, NV 89060 Town of Pahrump 2100 E Walt Williams Dr # 100 Pahrump, NV 89048 Phone: 77 5-727 -5107 x1 TownOffi [EMAIL REDACTED] McCullough Rodeo Arena Reservation Request Form o.ganiZatiOn I\Jnmg; Live A Little Entertainment croup Address: 111 N.3962 E. Rigby, 1D.83442 COntaCt: Kaedon Berry BeSt Email : [EMAIL REDACTED] Contact Phone: 479-209-255s Proj ected Attendees: 3ooo Event Descriptig11 Monster Truck lnsanity Tour (Motorsports Entertainment) TEES fOR USE: YEs FEE x_ Event DateS: May 5-6, 2023 Please select the options below that will apply to your upcoming event Event Times: Doors spm / Shows: 7pm SECURITY DEPOSM: YEs TEE DESCRIPTION X 5250 Deposits: Cleaning (Refundable) 52m [vestock Pen5 (Refundable) _ S25 Racetrack(cleaning-refundable) _ S5m Timers (Refundable) 5Lm0 AnnouncingEquipment(Refundable) _ $Smmin Rough Stock (Refundable) _ 5250 Timed event (Refundable) X 51,500 Damages (Refundable) Concession Stand {Non-tood) YEs TEE DESCRIPIION X StO Cleaning D€posit (Refundable) X S20 Damage Deposit (Refundable) Concession Stand (Food) YES FEE DESCRIPnON X SZm Cleaning Deposit X SZm Damage Deposit DESCRIPTION Arena Reservation Fee (Non-refundable) N on-profit use r fee (Arena Fee PLUs1096 of gate fees) For profit userfee {Arena tee PLUS 2096 ofgate fees) Horse Stalls - Per horse/per day {Non-refundable) Changes to facility (Non-refundable) Details: - Sts x TBD Concession Stand (Non.Foodl YES FEE _ 510x Non-profit userfee (perday) _ 520x For profit userfee (perday) Concession Stand (Food) YES IEE DESCRIMON X 520 Screen Cleaning (Non-refundable) _ _l'/on-prcfit userfee (tee PIUS 1096 of net profit) _ _Fo, profit userfee (Fee PIUS 20?6 of net profit) TOTAL TOTAL Ph6ns; [PHONE REDACTED] ---PAGE BREAK--- McCullough Rodeo Arena Reservation Request Form A Certificsae of Liabilitr Insurance naming the Ton n of P.hru mp as Certificate Holder or as Additionrll) Insured is MAI\TDATORY. Please submit a cop] ofyour liabitity irsurrnce with this form, ifyou are going to be usitrg the Bucking Shoots, this NIUST be on your insuralce polic] ts\'SIG,r.'lNG THIS FOR\'I. LAGREE TO THE FOLLO\\'NG: J will bchave rcsponsibly in accordancc with all the Pahrump McCullough Rodeo Arena rules as posted. Each group is responsible for leaving the Pahrump McCullough Rodeo Arena in the order in which it was found, picking up trash and taking all items that werc brought in, back out. J will maintain my general liability insurancc policy throughout the entfue duration ofthe approved reservation and will have rough stock addcd to my policy, ifapplicable. -l that I am using the Pakump McCullough Rodeo Arena at my own risk and do not hold rhe Town of Pahrump responsible for any damages and or injuries. Kaedon L. Berry 1117t23 Signature Date For Ofice Use Only: Reviewed by Pahrump Arena Advisory Committee: This event has beennAPPROVED /EDENIED by Pahrump Arena Advisory Committee Cornmittee Comrnents: