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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: 4/25/2023 <br />Applicant Signature:/IQiL¢t� (atlL <br />Printed Name: Karey Circosta <br />SPECIAL EVENTS COMMITTEE APPROVAL <br />i 44 <br />i <br />Pr ent <br />t j <br />Mem er <br />Member <br />Member <br />fin' <br />Me <br />S�e2�.23 <br />Date <br />