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PAHRUMP ARENA FACILITY RESERVATION FORM EVENT NAME: PHONE: ADDRESS: Deposits and fees must be paid and proof of required insurance must be provided 7-10 days prior to the event $ Arena Reservation Fee $ Non-profit user fee: $ For profit user fee: $ Horse stalls $ Deposits: Cleaning $ Livestock pens $ Racetrack (cleaning) $ Timers $ Announcing equipment $ Rough stock $ Timed event $ Changes to facility (Pre-paid, Non-refundable) Arena reservation fee plus 1 0% of gate fees Arena reservation fee plus 20% of gate fees (Non-refundable) $15/horse/day (Pre-paid, Refundable) $250 (Pre-paid, Refundable) $200 (Pre-paid, Refundable) $25 (Pre-paid, Refundable) $500 (Pre-paid, Refundable) $1000 (Pre-paid, Refundable) $500 min (Pre-paid, Refundable) $250 (Pre-paid, Non-refundable) Concession (food, drink, restrooms) $ Screen cleaning (Pre-paid, Non-refundable) $20 $ Non-profit user fee: $ For profit user fee: $ Deposits: Cleaning $ Damage Screen cleaning plus I 0% of net profit Screen cleaning plus 20% of net profit (Pre-paid, Refundable) $200 (Pre-paid, Refundable) $200 Concession (Non-food, non-drink) $ Non-profit user fee: $ For profit user fee: $ Deposits: Cleaning $ Damage $ Total (Per booth, per day) $10 (Per booth, per day) $20 (Pre-paid, Refundable) $10 (Pre-paid, Refundable) $20 Reservation fee is payable upon approval of this reservation. A (refundable) deposit of $ (check or money order only) and proof of required insurance will be submitted to the Pahrump Town Office 7-10 days prior to the event. Deposit will be held until all fees are paid, keys returned and arena cleared of event. Appeals heard by the Town Board. A copy of Arena by-laws was received: Proof of Non-Profit Status: Additional requirements:_ The following person is responsible for the arena complex on day(s) of event(s) and payment of all fees: Approved Keys out (date) Amount Returned Deposit returned Deposit returned White: Town Office, Yellow: Customer, Pink: Arena Barrel Race 1-11-2020 Marla Stevens - Because of Bailey [PHONE REDACTED] P.O. Box 4290 Pahrump Nv 89041 50) N/A N/A N/A 250 N/A N/A 500 1000 N/A 250 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 2050 2000 Marla Stevens 1-11-2020 Loyce Seastrunk 12--30-2020 ---PAGE BREAK--- McCullough Rodeo Arena Located inside Petrack Park 150N Hwy 160 Pahrump, NV 89060 Town of Pahrump 2100 E Walt Williams Dr #100 Pahrump, NV 89048 Phone: [PHONE REDACTED] xl McCullough Rodeo Arena Reservation Request Form Rxc Ct Contact Phone: 7) 77’7 Projected Attendees: I ‘T / F’ Ijqj)42 Event Dates. 77 Event Times: c’ 3 Please select the options below that will apply to your upcoming event: Concession Stand (Non-Food) YES FEE DESCRIPTION $lOx Non-profit userfee (per day) $20x For profit userfee (per day) Concession Stand (Food) YES FEE DESCRIPTiON $20 Screen Cleaning (Non-refundable) Non-profit user fee (Fee PLUS 10% of net profit) For profit user fee (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 Rought Stock (Refundable) $250 Timed event (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 Organization Name: Address: i -i R&&,v i\ Hk1 /1hi Contact: (5 .7 t ____Phone: .2 7- Best Email: Event Description: H ,9 t ,Jic’ L - c-fr- O(e 11CL, J(1f7, 0 FEES FOR USE: YES FEE $15x TBD DESCRIPTION Arena Reservation Fee (Non-refunable) Non-profit userfee (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: 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 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 out. -I 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. / ‘ 11 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: