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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: —7 l" 1.1 01`3 <br />Applicant Signature: <br />Printed Name: <br />rox <br />SPECIAL EVENTS COMMITTEE APPROVAL <br />.-7a - , 1�4 -Z1- <br />Preside t c l� <br />C� <br />• Member <br />Member <br />Member <br />-7-/i-a3 <br />Date <br />