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11 <br />Date: <br />I have read the Application and the Permit and Agreement for this Special Event and 1 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 />Anplirant Signature! <br />Printed Name: <br />President <br />Member <br />40 <br />CpF(IGI C\/CNTC rC)UUITTFL AOPPC)17AI <br />. _MemberMerr <br />e/IartI6IVC "ei-t ( i <br />Member <br />6 -G -13 <br />Date <br />