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. ain hon <br /> illa a <br /> Administrative Offices <br /> 3301 Silver Lake Road, St. Anthony, Minnesota 55418-1699 <br /> (612) 789-8881 FAX (612) 781-9323 <br /> City Hall/Community Center <br /> Facility Reservation Form <br /> Home Day <br /> Name Phone Phone <br /> Address <br /> Name of Group or Organization <br /> Class A: School organizations, community groups or not for profit individuals providing services or activities for the youth of <br /> I.S.D. #282, non-profit community groups and local civic organizations, i.e., Chamber of Commerce, Kiwanis. <br /> Certain circumstances may require fees. <br /> Class B: Political groups and religious/church organizations. School organizaitons other than SANB ISD #282, community <br /> • groups or not for profit individuals providing service for activities for non-resident youth, non-profit community <br /> groups and local civic organizations that are not located in the City of St. Anthony. <br /> Class C: Commercial and business organizations. <br /> Date(s) Wanted Day(s) Sun Mon Tue Wed Thur Fri Sat <br /> Room Requested Fee <br /> Council Chambers Gymnasium <br /> Kitchen Community Meeting Rooms <br /> Which one? <br /> Equipment Needed Fee <br /> I hereby certify that I am an agent of the above named group or organization and am authorized <br /> to accept in their name the responsibility for observance of the rules and regulations of the City <br /> of St. Anthony. In accepting this arrangement, rentee agrees to assume all responsibility for <br /> damage or liability of any kind of further agrees to hold the City of St. Anthony and its <br /> representatives harmless from any liability and/or expense in connection with the use of the City <br /> Hall/Community Center facilities. <br /> • <br /> Signature of Responsible Person Total Fee <br />