2. Name of Group*
3. Activity*
5. 
   
7. Contact Person*
8. E-mail Address
9. Address*
11. 
    
13. City*
14. State*
15. Zip Code*
17. 
    
19. Home Phone*
20. Bus Phone*
21. Cell Phone*
23. 
    
25. Park to be Used*
26. Area in the park used*
28. 
    
30. Date of event*
31. Set up Time*
32. End Time*
34. 
    
36. Estimated amount of people for your function:*

    1. 1 to 50
    2. 50 to 100
    3. 100 to 150
    4. 150 to 200
    5. 200 and up
38. 
    
40. Please read and check the following:*

    1. Group agrees to leave facility as found
    2. Village of Los Lunas will not be responsible for any injury or accident occurring during the use of the facility.
    3. Organization will be assessed the cost of repairs and/or replacement of Damaged Property and/or equipment as determined by administration personnel.
    4. Once approved agreement must be available at the time of your function
    5. NO ALCOHOLIC BEVERAGES ALLOWED
42. 
    
44. Approved by Police Department:*

    1. Yes
    2. No
46. 
    
48. Comments:
50. 
    
52. NOTE: There is a $25.00 fee charged for day use. If electricity is needed the fee is $75.00 a day(where available).
54. 
    
56. This request will be reviewed and you will be contacted by phone or email within 3 business days. Please visit our office at 101 Courthouse Rd or call 352-7717 when requesting an area that does not meet these time constraints.
Leave This Blank:


58. 1. Receive an email copy of this form.
59. Email address

    This field is not part of the form submission.

60. Submit Submit and Print

* indicates a required field