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McCullough Rodeo Arena Town of Pahrump Located inside Petrack Park 2100 E Walt Williams Dr #100 150 N Hwy 160 Pahrump, NV 89048 Pahrump, NV 89060 Phone: [PHONE REDACTED] xl McCullough Rodeo Arena Reservation Request Form Organization Name: Address: l7o W, Contact: G - - Best Email: /o € V Event Description: 3 /7 8/a 8 Event Times: Please select the options below that will apply to your upcoming event: SECURITY DEPOSITS: DESCRIPTION ,K $250 Deposits: Cleaning (Refundabe) $200 Livestock Pens (Refundabe) > $25 Racetrack (cleaning-refundable) $500 Timers (Refundable) $1,000 Announcing Equipment (Refundable) $S00min RoughStock(Refundable) $250 Timed event (Refundable) $1,500 Damages (Refundable) Concession Stand (Non-Food) YES FEE DESCRIPTION $10 Cleaning Deposit (Refundable) $20 Damage Deposit (Refundable) Phone: 7 -37/ 5 Contact Phone: 77 $537- 5’6’/5 Proj ected Attendees: / 5€2 Event Dates: FEES FOR USE: YES FEE $15x TBD 9;)1-7 /77 DESCRIPTiON Arena Reservation Fee (Non-refundable) Non-profit user fee (Arena Fee PLUS 10% of gate fees) For profit user fee (Arena Fee PLUS 20% of gate fees) Horse Stalls - Per horse/per day (Non-refundable) Changes to facility (Non-refundable) Details: Concession Stand (Non-Food) YES FEE DESCRIPTION — $lOx Non-profituserfee(perday) $20x For profituserfee (perday) Concession Stand (Food) YES FEE DESCRIPTION — $20 Screen Cleaning (Nonrefundable) Non-profit user fee (Fee PLUS 10% of net profit) For profit userfee (Fee PLUS 20% of net profit) Concession Stand (Food) YES FEE DESCRIPTION $200 Cleanng Deposit $200 Damage Deposit TOTAL TOTAL ---PAGE BREAK--- McCullough Rodeo Arena Reservation Request Form A Certificate of Liability Insurance naming the Town of Pahrump as Certificate Holder or as Additionally Insured is MANDATORY. PLease submit a copy of your Habifity Insurance with this form, If you are going to be using the Bucking Shoots, this MUST be on your insurance policy BY SIGNING THIS FORM, I AGREE TO THE FOLLOWING: -I will behave responsibly in accordance with all the Pahrump McCullough Rodeo Arena rules as posted. Each group is responsible for leaving the Pahrump McCullough Rodeo Arena in the order in which it was found, picking up trash and taking all items that were brought in, back ouL -1 will maintain my general liability insurance policy throughout the entire duration of the approved reservation and will have rough stock added to roy policy, if applicable. -I understand that I am using the Pahrump McCullough Rodeo Arena at my own risk and do not hold the Town of Pahrump responsible for any darn s and or injuries. Signature Date For Office Use Only: Reviewed by Pahrump Arena Advisory Committee: This event has been APPROVED / DENIED by Pahrump Arena Advisory Committee Committee Comments: ---PAGE BREAK--- McCullough Rodeo Arena Located inside Petrack Park 150N FIwy 160 Pahrump, NV 89060 Town of Pahrump 2100 E Walt Williams Dr #100 Pahrump. NV 89048 Phone: [PHONE REDACTED] xl TownOfficepahrumpnv .org McCullough Rodeo Arena Reservation Request Form Organization Name: —f-47 /4 Address: 7 £#4r 1- U Phone: 7oZ— yt3 Y9 \ Sc Contact Phone: 7o2- Z3 - a y o ec/ ‘$oScted Attendees: 1$ O Event Description: Cn Cr4— -Js g” dc,- -e-r- if! Sc t-O ( S4—i :c Event Dates: /14.rCLi 2 Event Times: Please select the options below that will apply to your upcoming event: FEES FOR USE: YES FEE DESCRIPTION Arena Reservation Fee (Non-refundable) Non-profit user fee (Arena Fee PLUS 10/ of gate fees) For profit userfee (Arena Fee PLUS 20% of gate fees) $15 x Horse Stalls - Per horse/per day (Non-refundable) TBD Changes to facility (Non-refundable) Details: Concession Stand (Non-Food) YES J DESCRIPTION $lOx Non-profit userfee (per day) $20x For profit userfee (perday) Concession Stand (Food) YES FEE DESCRIPTION / $20 Screen Cleaning (Non-refundable) Non-profit user fee (Fee PLUS 10% of net profit) For profit userfee (Fee PLUS 20% of net profit) SECURITY DEPOSITS: YES FEE DESCRIPTION $250 Deposits: Cleaning (Refundable) $200 Livestock Pens (Refundable) $25 Racetrack (cleaning-refundable) $500 Timers (Refundable) $1,000 Announcing Equipment (Refundable) $500 mm Rough Stock (Refundable) $250 Timed event (Refundable) $1,500 Damages (Refundable) Concession Stand (Non-Food) YES FEE DESCRIPTION $10 Cleaning Deposit (Refundable) $20 Damage Deposit (Refundable) Concession Stand (Food) YES FEE DESCRIPTION $200 Cleaning Deposit $200 Damage Deposit Contact: Best Email: -k TOTAL TOTAL ---PAGE BREAK--- McCullough Rodeo Arena Reservation Request Form A Certificate of Liability Insurance naming the Town of Pahrump as Certificate Holder or as Additionally Insured is MANDATORY. Please submit a copy of your liability insurance with this form, if you are going to be using the Bucking Shoots, this MUST be on your insurance policy BY SIGNING THIS FORM, I AGREE TO THE FOLLOWING: -I will behave responsibly in accordance with all the Pahiump McCullough Rodeo Arena rules as posted. Each group is responsible for leaving the Pahrunip McCullough Rodeo Arena in the order in which it was found, picking up trash and taking all items that were brought in, back out. -1 will maintain my general liability insurance policy throughout the entire duration of the approved reservation and will have rough stock added to my policy, if applicable. -I understand that I am using the Pahrump McCullough Rodeo Arena at my own risk and do not hold the Town of Pahrump responsible for any damages and or injuries. For Office Use Only: Reviewed by Pahrurnp Arena Advisory Committee: Date This event has been APPROVED / DENIED by Pahrump Arena Advisory Committee Committee Comments: