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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: /Z -N- ZozZ <br />Printed Name: <br />SPECIAL EVENTS COMMITTEE APPROVAL <br />&20 }�ohr5elxeb (OM) ^TOG Uf III COWL <br />President <br />f/,�td,�lYt �ID�QLI Ci3fY1% <br />Member i <br />Member <br />G-e r-3 v-d E1 /l S (am) <br />Member <br />a - <br />Date <br />