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ROSEVILLE PARKS & RECREATION <br /> 2660 Civic Center Drive Roseville, Minnesota 55113 <br /> Phone: 651-792-7006 - Fax: 651-792-7100 <br /> OUTDOOR FACILITY AGREEMENT <br /> Name of Contact: <br /> Name of Organization/Event: <br /> Mailing Address: City/State/Zip- <br /> Phone#1: Phone#2: <br /> E-mail: Estimated Attendance: <br /> FIRST CHOICE FACILITY, DATE AND TIME <br /> Facilit y Requested: Date Requested (M/D/Y): <br /> O Mon O Tues O Wed O Thur O Fri O Sat O Sun <br /> Time Slot Requested: O 9 am - 3 pm O 4 pm - 10 pm O 9 am - 10 pm <br /> SECOND CHOICE FACILITY, DATE AND TIME <br /> Facilit y Requested: Date Requested (M/D/Y): <br /> O Mon O Tues O Wed O Thur O Fri O Sat O Sun <br /> Time Slot Requested: O 9 am - 3 pm O 4 pm - 10 pm O 9 am - 10 pm <br /> Special Considerations: <br /> O 3.2 % beer permit O Amphitheatre staffing fee - $25/hr <br /> O Special Use Permit (2 hour nonrefundable minimum) <br /> O play kit O Outside Vendors <br /> FORM OF PAYMENT <br /> O cash O check O Visa O Master Card O American Express Amount Paid $ <br /> Credit Card # <br /> Expiration Date / Name as it appears on the card: <br /> Acknowledgement of Facility Agreement: <br /> Refund Policy: All requests for refunds, due to cancellation are subject to a cancellation fee. <br /> $7 fee is charged for any changes made after original permit has been issued. <br /> Refunds, less a $10 administrative fee, are issued on cancellations made 46 or more days prior to scheduled <br /> reservation Refunds less$35 for half day and $45 for full day fee, will be issued for cancellations made 11-45 days <br /> prior to scheduled reservation. <br /> No refund given for cancellations 10 or fewer days before scheduled reservation, nor are refunds made due to weather <br /> - unless weather condition is deemed severe i.e. tornado. <br /> Key Policy:New for 2011 $25 deposit due upon making facility reservation. <br /> This deposit will be refunded following the timely return of the key. Credit card payments returned the next business <br /> day, cash and check payments are refunded by check within 10 business days. <br /> Complete key deposits are refunded as long as the shelter site is free of damage and shelter clean up is completed by <br /> permit holder. Deposit is required for shelters that include kitchen /bathroom facilities. <br /> Key pick-up hours: Monday- Friday 8am-4pm KEYS MAY NOT BE PICKED UP ON WEEKENDS! <br /> Use of the shelter is limited to reserved time only. Food or other materials are not to be stored in shelter prior to rental. <br /> I have received, read and understand the terms of agreement for the use of Roseville's outdoor facilities. <br /> Signature of Rental Party Date <br /> Thank you for choosing Roseville Parks and Recreation for your special event. <br />