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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 — 9,3 <br />Applicant Signature: <br />Printed Name: U O N A I d 6 9 0 rn e i I N 9 <br />SPECIAL EVENTS COMMITTEE APPROVAL <br />President <br />► 1 Member <br />�i2r1offc 6rlyk(19r1) <br />Member <br />G -4 ,23 <br />Date <br />