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SECTION 2 Must be completed if: *Your event is open to the public <br /> 'You are fundraising or charging a fee <br /> *you are requesting a full or partial fee reduction <br /> 1. Give a brief history of your organization and its mission/inte t: <br /> Sa ciiit 'e, e fe�511XJr cP Assr <<-,: �'vF, (//�.5©t) p i tni 1- C r—71Ic*S 41,, <br /> e, � J 4 (47.>—/"C'=tics 7/'e .cj- i"›/f<xc� e-N . -:, t:J.e. ,.XCS --I it• 0..'e> ;t".i i:-- `17 iL' i <br /> 'uc 4:S ,y4 ,..1 _'vim <br /> 2. Please list list name and title of current officers and/or board members: <br /> i eekl ( <br /> `\ 4"::41G`I�.ST..,14 i U f*�Fx So,, — -/i,-`P,ae sCe.Fa^ ,_ <br /> 6.J.:,t.:A,.?f9 ..14,-u. A..);Zs Ga -- 134.— 1,--d (Lt.e-E. e34,- <br /> 13. How will the public be notified of this activity/event? <br /> 0 Newspaper Advertisement XPress Release <br /> 0 Radio/TV Other(please explain) <br /> • 4. Provide a budget summary of projected revenue and expenses for this event: <br /> Please note that fundraisers cannot be considered for partial or reduced fees and will be required to pay — <br /> full rental fees on facilities.Events must not discriminate because of age,sex,marital status, race, creed, <br /> color, national origin or presence of sensory, mental or physical disability. No events sewing alcohol will <br /> be co-sponsored by the City of Everett. _ <br /> Please allow 30 days for processing your request. Thank you. <br /> OFFICE USE ONLY BELOW THIS LINE <br /> 0 Approved <br /> 4. Approved with noted stipulations <br /> o Unapproved <br /> Recreation Assistant Director Signature Date Application expiration date <br /> (No more than one year from date <br /> • of Assistant Directors signature) <br /> Recreation Coordinator Signature Staff Liaison to event <br /> Category of use: 0 Recreation Oriented Group function ❑Teen function category <br /> 0 Co-sponsored event/activity ❑ Private rental <br /> 0 Interagency/Enter-local Agreement D Other <br /> O Charitable fundraiser(no fee reduction can be authorized by Park staff) <br /> Notes: <br /> s:\#common\recreation\special use12014 special use form and hold harmless 10-31-13.docx <br /> 12 <br />