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OLD FIRE HALL <br />CITY OF LITTLE CANADA <br />FACILITY PERMIT APPLICATION <br />Contact Person <br />Mailing Address City Zip <br />Home Phone Business Phone <br />Sponsoring Agency Of Event Type of Event <br />Day and Date of Use <br />Estimated Attendance Set -Up Time <br />Guest Arrival Time Completion Time <br />Alcoholic Beverages to be served? Yes No <br />Food to be served? Yes No <br />Admission to be charged? — Yes _ No Advance Tickets Sold? _ Yes No <br />Upon application approval the City of Little Canada shall make available to the hold of <br />this permit the Old Fire Hall for use on the date specified. The City shall not be <br />responsible for providing food, bar services, supplies or supervision of the activities <br />conducted by the holder. The City reserves the right to exercise supervisory authority <br />and to prevent unauthorized or illegal activities on City property. The City shall not be <br />responsible for interruptions of the use of the described facilities for reasons beyond its <br />control, and reserves the right to cancel this permit for reasons of public safety or <br />convenience. <br />I (We) represent and agree that I (We) have read and understand the information <br />regarding the use of the Old Fire Hall, including cancellation procedures, liabilities and <br />responsibilities assumed, times and curfews, and maximum room capacities. I (We) <br />further understand that this is only an application for use which provides me (us) with no <br />assumed or implied rights for use until written approval is received. I (We) further <br />understand that fees paid by me (us) are refundable only in accordance with City policies <br />recited in the Rental Rules and Regulations for the Old Fire Hall. <br />Specifically, and without limiting the generality of the foregoing, the holder of this <br />permit agrees to save, defend and hold harmless the City for any damages to City <br />personnel, facilities, equipment or other City property or to the property and /or person of <br />any third party, resulting from the use authorized hereby. The City shall not be liable for <br />damage to the property of any person participating in the activities authorized hereby, nor <br />Page 47 <br />