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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 />`j/ iS /zozy <br />Applicant <br />Printed Name: 11-Z oI 'Do4 r, 5 <br />• <br />President <br />Member Member <br />0 <br />' `la <br />Member <br />/a/ b <br />Date <br />