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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: <br />Applicant <br />Printed Name: Ja <br />Pksident <br />Mer <br />SPECIAL EVENTS COMMITTEE APPROVAL <br />ember <br />Member <br />Member <br />i- 13-')-I <br />Date <br />