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� <br />EN HILLS <br />Name/4rganization: <br />Address: <br />Cantact Person: <br />Phone: �� <br />City/State/Zip Email: <br />Todap's Date <br />Park: DaylDate: <br />Nature of Event: Arrival Time: <br />Estimated Attendance: Completion Time: <br />A�nenities Needed: <br />❑ Picnic Shelter (w/3 tables) ❑ Ball Field{s) ❑ Hockey Rink ❑ Tennis Court <br />❑ BasketbaIl Court ❑ Soccer Field ❑ Wartning House ❑ Picnic Pavilion (w/5 tables) <br />All amenities listed ahove are based on availability. C�m�r►ings Park/�erry �ark o,�ly. <br />Indoor bathrooms, sink & small refrigeratar <br />Additional Picnie Tables: ($5.3b charge for every set of 2 additional tabies and 1 trash container requested.) <br />Resident Non-Pro$t Organization <br />4ther Non-Profit <br />Resident <br />Non-Resident <br />Damage Deposit (s�parate check) <br />(refunded upon approval by staf� <br />Key Deposit (sepaxate check) <br />(refunded upon appraval by staf� <br />Picnic Shel�er <br />*$10.72 <br />*$37.50 <br />*$37.50 <br />*$53.57 <br />$100.00 <br />$50.00 <br />*Tnc�udestaY <br />Ficnic Pavilion <br />* $26.79 <br />*$53.57 <br />*$53.57 <br />*$69.64 <br />$100.00 <br />$sa.ao <br />I have received a copy af the park reguIations. I understand that while using the park I and my guests must abide by the <br />rules stated in the park regulations. I further understand that my c�amage deposit or parts thereof rnay be forfeited if I or my <br />guests cause damage to the facility or if the facility is not returned to its previous condition. Also, I will forfeit my key <br />deposit if the buiiding key is not r�turned in a timely manner. <br />CYTY OF ARDEN HYLLS <br />1245 West Highway 96 <br />Arden Hills, Minnesota 55112 <br />Phone: 651.792.7800 <br />Fax: 651.634.5137 <br />Pa� �NTaL APPLiCAT�oN <br />Applicant Signature: Date:: <br />