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ROSEVILLE PARKS & RECREATION <br /> 2660 Civic Center Drive - Roseville, Minnesota 55113 <br /> Phone: 651-792-7000 - Fax: 651-792-7100 <br /> OUTDOOR FACILITY RENTAL AGREEMENT <br /> Name of Contact- DOB: <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 /> Facility Requested- Date Requested (M/D/Y)- <br /> 0 Mon 0 Tues 0 Wed 0 Thur 0 Fri 0 Sat 0 Sun <br /> Time Slot Requested- 0 9am - 3pm 0 4pm - 10pm 0 9am - 10pm <br /> SECON© CHOICE FACILITY, DATE AND TIME <br /> Facility Requested- Date Requested (M/D/Y)- <br /> 0 Mon 0 Tues 0 Wed 0 Thur 0 Fri 0 Sat 0 Sun <br /> Time Slot Requested- 0 9am - 3pm 0 4pm - 10pm 0 9am - 10pm <br /> Special Considerations: <br /> 0 3.2 % Beer Permit 0 Amphitheatre Staffing Fee -$25/hr <br /> 0 Special Use Permit (2 hour nonrefundable minimum) <br /> 0 Play Kit 0 Outside Vendors <br /> FORM OF PAYMENT <br /> 0 Cash 0 check 0 Visa 0 Master Card 0 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 in 2011 $25 deposit due upon making facility reservation. <br /> Deposit is required for shelters that include kitchen/bathroom facilities. This deposit will be refunded following the <br /> timely return of the key. Credit card payments returned the next business day, cash and check payments refunded by <br /> 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. <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 />