City Facility/Park Reservation Application

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City Facility/Park Reservation Application Applicant Name: Phone: ( ) Cell: ( ) Email: Facility/Park Requested: Facility/Park Name: Time of Event: am/pm to am/pm Date of Event: (Reservation time MUST include set-up and take-down) Type of Event: Number of Attendees: Time Guests will arrive: am/pm Is this a West Sacramento Athletic Roundtable Sponsored Event? Yes No Primary Contact Person: Name: DOB: Phone: ( ) Cell: ( ) Email: Secondary Contact Person: (This person will be contacted if the primary contact person is unavailable) Name: Phone: ( ) Cell: ( ) Please describe in detail, what activities will occur at this event.

Permits Information Will you be having any of the items listed below at your event? If so, you may be required to obtain a Special Event Permit or other required permits. (Please circle Yes or No to any items below for your event) 1. Do you plan to have alcohol at this event? 2. Do you intend to sell alcohol at this event? Yes Yes No No If alcohol is sold, an Alcoholic Beverage Control permit is required. 3. Will admission be charged to attend this event? Yes No 4. Will you be selling anything at this event? (i.e. raffle tickets, drinks) Yes No If yes, what will you be selling? 5. How will selling be conducted? (i.e. booths, vendor carts, walking vendors) 6. Will food be provided at this event? Yes No If yes, it is possible that a Yolo County Health Department Permit will be required. 7. Will there be amplified sound at your event? Yes No 8. Is this a fund-raising event? Yes No 9. Will you be using any tent canopies or awnings over 200 square feet? Yes No Liability Waiver I, (print name) _, certify that by affixing my signature hereto that I am an authorized representative of [ _], I am over eighteen (18) years of age; and that [on behalf of said organization] I have read and understand the City of West Sacramento recreation facilities' policies, rules and regulations, and above terms and additional conditions, if any, and that I [said organization] shall abide by them; I am fully aware that responsibility for the safety and well-being of all persons who participate or observe in said [organization's] activities is ours; and, I agree that the City of West Sacramento, its City Council, Officers, Agents, and Employees are released, indemnified, and held harmless from any and all claims, causes or action, losses, costs, expenses, damages, or other liabilities for personal injury or death or property by any person or person connected with said activities that may be sustained, caused by or alleged to have been caused by or arising out of the use of the above facility [by said organization.] I further agree that I/said organization will leave said facility in same or better condition in which it is presented to myself/said organization. If the facility is not cleaned or damage occurs, the deposit will be used to restore the facility to the condition in which it was presented to myself/said organization. If damage exceeds the deposit amount, I/said organization will be billed for the remainder. Applicant Name: Applicant Signature: City of West Sacramento Parks & Recreation signature below indicates approval of application. City Staff Signature: Phone: Title: Cancellation & Refund Policy Rental deposits paid with a credit card more than 90 days in advance will be refunded by check within 2-4 weeks following the rental. No Refunds will be issued for events cancelled without a 14 day notice of event cancellation. Renter s Initials Date

Date entered: Staff Initials: Recreation Center Rental Guidelines 3 City of West Sacramento Recreation Center Rental Guidelines & Information Reservations/Deposits Steps: 1. Requests must be made a minimum of 14 days prior to the event date but not more than one year out. 2. Submit Universal Reservation Application & Recreation Center Rental Guidelines. 3. Requests are tentative until the $250 refundable security deposit has been paid. Deposit is separate from the hourly rental fees and is refundable. 4. All rental fees must be paid two weeks prior to the event date. Business** & Party Rooms* Select all that apply. *Non-Resident Rooms *Resident Rates Rates Room Capacity Refundable Deposit Party Room $20.00 /hr * $30.00 / hr * 25 people $250 Comm. Rm. B $30.00 /hr * $40.00 / hr * 40 people $250 THEMED PARTIES Rentals available outside of programed hours. Party room access includes an additional 30 min set-up and clean-up. ROCKWALL $240.00 $200 includes 15 PARTY! includes 15 climbers, each Best serves 15-25 2 hours of Rock climbers, each additional climber climbers Wall use & additional is $6.50. Party Room climber is $6.50. SABER FITNESS PARTY! Use of party room & a special 30 min Kids Saber Fitness routine. $200 includes 13 Kids Saber participants, each additional participant $6.50. $240 includes 13 Kids Saber participants, each additional participant $6.50. Best serves 13 participants. More participants would likely need a 2 nd 30 minute routine. $250 $250 *Some rentals may require the purchase of day passes. **Insurance is required for non-profit or business rentals. Ask for non-profit rates. Equipment Requested: Description Available # Size # Requested Rectangular Tables 14 30 in x 60 in seats 6 adults each Chairs 65 Black Plastic, sled type Projector and Screen $25 use fee 1 AV System

Recreation Center Rental Guidelines 4 Initial Rental Applications and Guidelines - Requests are typically reviewed within two (2) business days and are subject to approval based on facility and staff availability. Specific policies include: Facilities will not be rented for any programs similar to the WSRC programs. Events requiring major set-up (floor tarp, etc.) should be submitted at least two (2) months prior. A detailed description of the activity and set-up should be included. Once the rental application has been approved you will be required to pay for the security deposit within 3 days of approval or the rental could be removed from the calendar. Initial Pre and Post-Inspections An authorized representative must meet City staff at the beginning and end of your event for a facility inspection. Failure to return the facility to the condition it was found will result in forfeiture of all or a portion of your deposit. Initial Rental Times can be on weekdays between 7 am and 9 pm and on the weekends the rentals can begin as early as 9 am and must end by 7 pm. We require that you include one hour to your rental time for set up and clean up. See breakdown/cleaning for more info. nitial Renter and Guest Policies and Procedures Initial Renter and Guest Policies and Procedures Renters and guests must follow the established WSRC rules and regulations. Violations of such regulations or misrepresentation of use may be cause for immediate cancellation of the rental without a refund. In addition, these guidelines must be followed: nitial Renter and Guest Policies and Procedures Renter must be present during the entire event and will need to assist with admittance. Renter must have all guests enter their name on a sign-in form to verify their attendance. It is the renter s responsibility to supervise all guests, including restricting guests to authorized areas only. The renter is held liable for their group s actions including any damages or loses caused during rental to the WSRC. Rentals shall not infringe on or restrict the use of other facilities in the WSRC. Any large events during school hours must first receive approval from the principal or his/her designee. Alcohol, smoking or other tobacco products is not permitted on WSRC grounds. All furniture, equipment decorations and other needs shall be detailed in the request and approved in advance. Only music suitable for a public facility will be permitted. The volume is subject to control by the Manager on Duty as they use their best judgement. Any material (pamphlets, etc.) containing advertising must first be approved before distribution. Initial Food and Catering Policy Outside food/drinks must be approved prior to rental. The kitchenette shall only be available for use during the time period approved on the Rental Contract. The renter shall completely clean all surfaces, appliances and equipment in the rental area. Any group requiring a catering service must provide the caterer s license number before the request can be granted. Initial Security Deposits MUST be paid within three (3) days from creation of invoice on your account; failure to comply will result in the removal of your rental request from the calendar. Initial Rental Fees must be paid a minimum of two (2) weeks prior to event; failure to do so may result in cancellation of any scheduled event. The rental will not be finalized until the full payment is received. Initial Changes - Any changes to the rental must be submitted in writing prior to the rental date. If the change is approved, it must be signed and dated by both the renter and the Rental Coordinator. WSRC reserves the right to deny any change to the rental request.

Recreation Center Rental Guidelines 5 Initial Set Up/Decorating The renter is responsible for all setup and take down needed for your event. It is required to have table coverings for all tables used during the rental. Decorations: Carpenter/painters tape is the only item allowed for securing your decorations to the tables, walls, and windows. No staples, nails, or tacks. Metallic decoration sprinkles, glitter, confetti, rice, and birdseed are not allowed inside or outside of the facility. Candles must be in a container; however we will not allow torches, and hibachis. User must furnish their own decorating supplies (i.e., scissors, helium, etc.). Initial Breakdown/Cleaning is to take place within the allotted time as indicated on the application. A checklist will be available at the start of your rental. It should be initialed as appropriate and presented during post-inspection. In order to receive a security/cleaning deposit refund, the renter must do the following: Leave the Recreation Center and surrounding area in the condition it was found. Nothing can be left on the premises overnight. The renter may not come in early the next morning for clean-up. Sweep and mop the floor of indoor facilities. Bring rags and cleansers to clean tables. Put away all tables and chairs. Initial Equipment/Amenities - AV and PA equipment available upon request prior to day of rental for an additional $25. Initial Insurance Requirements for Business or Non-Profit Rentals Certificate of Insurance for COMPREHENSIVE GENERAL or COMPREHENSIVE PERSONAL LIABILITY coverage for a minimum of $1,000,000. This can normally be obtained from the renter s insurance agent. The following statement must appear on the certificate: Additional Insured Endorsement names the City of West Sacramento, its officers, officials, employees, and volunteers as additional insureds. Also include facility name and date of event. Initial City Staff- A City facility attendant will be present in the building the entire duration of your event. The facility attendant will unlock the rooms for the renter. Any directions or instructions from that facility attendant are to be followed for the safety and security of the building and all its users. Please report any safety issues immediately to that person. The facility attendant has the authorization to stop or modify the event if deemed necessary or if the application information is found to be false. Initial Security- the City reserves the right to require security and/or attendant service at any events. Any cost associated with this is the renter s responsibility. Please contact (916) 617-4770 with any questions or email recreation@cityofwestsacramento.org Renter s Signature: Name of Renter: Contact #: Employee s Signature: Staff Use: Total Amount Due: Deposit Amount Received: Deposit Receipt #: Date Liability Insurance Submitted: (As required by City) Special Event Permit Approval Total Amount Paid: Date Received: Paid by: Check Cash Credit Card Other Refunded Deposit - Date Processed: Receipt #: Received by: Amount use and for what purpose: Amount returned to renter: