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Town of Pahrump 2100 E. Walt Williams Drive, Suite 100 Pahrump, NV 89048 Phone: [PHONE REDACTED] Pahrump Community Parks Special Event Rental Agreement NAME: ADDRESS: CONTACT PHONE: EMAIL:_ - - - - - - - - - - - - - - - EVENT NAME: EVENT TYPE: START DAY: END DAY: NUMBER OF EXPECTED PARTICIPANTS: Certificate of Liability Insurance naming the Town of Pahrump as Certificate Holder or as Additionally Insured will need to be submitted prior to event starting. Number of Overnight Permits Required: Overnight Permit Approved? YES NO PLEASE INDICATE WHICH PARK YOU WILL BE USING: User Fee: $500 Petrack Park Ian Deutch Park Simkins Park Would you like your event placed on the marquee? YES NO If yes, what wording: Please note marquee space is limited. Town of Pahrump reserves to right to remove, replace, or deny space on the marquee. Special Requests: Is electricity needed: YES NO Will anyone be selling food or alcohol? YES NO DEPOSIT: $300 REFUNDABLE IF PARK AREA IS CLEANED AND NOTHING IS BROKEN OR DAMAGED. If the event is cancelled and notice is not received by the Town of Pahrump within one week of the schedule event, $100.00 will be retained for administrative/maintenance fees. The deposit shall be in the form of a cashier’s check, money order or personal check, payable to the Town of Pahrump. Deposit must be submitted to the Town Office. If not received, the event is subject to cancellation. EVENT WILL NOT BE POSTED TO THE CALANDER UNTIL DEPOSIT AND PAYMENT ARE RECEIVED. BY SIGNING THIS FORM, I AGREE TO: -Behave responsibly in accordance with all park rules as posted. Each group is responsible for leaving the park area in the order in which it was found, picking up trash and taking all items that were brought in, back out. -Complete any required vendor paperwork should there be any intent to sell food, alcohol, or merchandise at the event and supply it to the Town Office no later than ten (10) days prior to the event. Signature Date