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I have read the Application and the Permit and Agreement for this Special Event and I affirm the truth of <br />the information provided by me to the best of my knowledge. I understand and agree to the above rules <br />and regulations, and any applicable state and federal laws. I also understand that this application may be <br />denied based on any false or incomplete information. <br />Date:9- -J-4z <br />Applicant Signature: <br />Printed Name: <br />Pre Went <br />Me ber <br />I — <br />SPECIAL EVENTS COMMITTEE APPROVAL <br />Member <br />Member <br />—7—a-, .JCC <br />Membe <br />Date <br />