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• <br />• <br />0 <br />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: 5- / - ,I oa 3 <br />Applicant <br />Printed Name: _[� ,L%�%�E� z • <br />Pre 'dent c' . <br />Wv <br />Mem er <br />SPECIAL EVENTS COMMITTEE APPROVAL <br />u�i'TI -M <br />Member <br />5-/&';13 <br />Date <br />