Choose your park:
Proposed use for facility:
Anticipate attendance:

Specific Uses for the Facility:

Shelter
Soccer Fields	How many?
Baseball Diamonds	How many?
Teams:

Dates and Times:

Date(s) of use:
Time(s) of use: From:		To:
Sponsoring Organization:
Special arrangements needed:

Terms and Conditions:

This Agreement, when signed by the applicant and a representative of the City of Riverside, as designated by the City Manager and/or Director of Public Services\City Engineer, constitutes a contract binding both parties to certain obligations.

The City of Riverside is an Equal Opportunity community and does not discriminate in its actions, procedures, or policies, based on race, color, religion, gender, national origin, disability, age, or sexual orientation.

The Applicant agrees to observe and obey all Park Rules and Regulations and Liability Agreement/Harmless Agreement.

Agree to Park Rules and Regulations: (Enter your initials to indicate agreement)	Agree to Liability Agreement/Harmless Agreement: (Enter your initials to indicate agreement)

Applicant Information:

Name:
Address:
City, State, Zip:
Phone (day):
Phone (eve):
eMail: