Clarke Estate Application

Clarke Estate Application

Department of Parks and Recreation
FACILITY USE AND APPLICATION

Event Information
Event Type
Date of Event

MonthDayYear
Date
Estimated Attendance

Applicant Information
Applicant Full Name
Address
City
State
Zip Code
Email Address
example@example.com
Phone
Date of Birth

MonthDayYear
Date

Organization Information (If Applicable)
Organization
Address
City
State
Zip Code
Email Address
example@example.com
Phone

CELEBRANT
NAME
Address
City
State
Zip Code
Email Address
example@example.com
Phone
Date of Birth

MonthDayYear
Date

CELEBRANT
NAME
Address
City
State
Zip Code
Email Address
example@example.com
Phone
Date of Birth

MonthDayYear
Date

Venue Selection
Ceremony

Courtyard (max 100)Backyard (max 200)Dressing Room (Bridal Party only)
Reception

Courtyard (max 80)Backyard (max 200)

Reservation Information
Set-Up Begins
Set-Up ends
Event Begins
Event Ends
Clean-Up Begins
Clean-Up Ends
Includes designated event time, 3 hours of set-up, one hour of clean-up.
Is your event catered?

NoYes
Caterer
Music Type/Name of DJ (see policy)
Alcohol Served - Must be from our exclusive bartender list

NoYes
Alcohol Sold - requires ABC Permit

NoYes
Event Fees
Funeral Fees

Credit Card Authorization
The City reserves the right to charge the Renter’s credit card on file for any costs incurred as a resultof damages, vandalism, excessive trash, failure to clean and restore the facility to its originalcondition, unauthorized use of equipment or areas, and/or any additional time beyond thecontracted rental period. All associated fees will be assessed based on actual repair, replacement,cleaning, or staffing costs as determined by the City
CANCELLATIONS
Down payment will be held if cancellation takes place less than six (6) months of event. A $100.00 non- refundable fee will be charged for event cancellation between six (6) months to one (1) year of event date.
LIABILITY AND AUTHORIZATION
I HEREBY CERTIFY THAT ALL INFORMATION IS TRUE AND ACCURATE. I HAVE CAREFULLY READ THE FACILITY RESERVATION POLICY AND USE POLICY, AND AGREE TO UPHOLD THE RULES AND REGULATIONS LISTED IN THE POLICY. I RELEASE, HOLD HARMLESS, AND AGREE NOT TO SUE CITY, INCLUDING PHOTOGRAPHY / VIDEO RELEASE, AND I FULLY UNDERSTAND ITS CONTENTS.

I AM AWARE THAT THIS IS A FULL RELEASE OF ALL LIABILITY AND I SIGN IT OF MY OWN FREE WILL. I UNDERSTND THAT THE CITYRESERVES THE RIGHT TO CHANGE, OR CANCEL ANY RESERVATION, AT ANY TIME, RESULTING FROM CITY ACTIVITY AND/OR MAINTENANCE.
Applicant Signature

Clear
Date

MonthDayYear
Date

CREDIT CARD AUTHORIZATION
I, Full Name* understand and agree that I am allowing a security deposit hold on my credit/debit card for a security deposit in the amount of $_____________ to reserve a City of Santa Fe Springs facility, Name of Facility* on Date* This security deposit hold is due at the time the facility reservation application is submitted. I understand the City of Santa Fe Springs Parks and Recreation Department will place an authorized hold on my credit/debit card in the amount listed above, and that amount will not be applied to the balance of the rental fees. In the event of damage to the facility, or if the City should incur any additional costs during the time of my rental, I agree to forfeit all or a portion of my security deposit amount. Should no additional charges be incurred, and the facility is returned in its pre-event condition, this security deposit authorization slip shall be destroyed and the hold on my credit/debit card by the City will be released. In the event the damages exceed the security deposit amount, or the credit/debit card has insufficient funds, I understand I am responsible for all costs associated with the excess fees, as well as any fees incurred from collection of those funds.
NAME AS IT APPREARS ON CARD*
CREDIT CARD TYPE*

MasterCardVisaAmerican Express
LAST 4 DIGITS*
EXPIRATION DATE*
CVC NUMBER*
ZIP CODE*
DRIVER LICENSE NUMBER*
DRIVER LICENSE STATE*
DRIVER LICENSE EXPIRATION DATE*
Signature

Clear
Date

MonthDayYear
Date
Click here for the full version of the Faciliity Reservation User Policy 2026

Should be Empty:

Clarke Estate Application

FACILITY USE AND APPLICATION

Event Fees

Funeral Fees

CANCELLATIONS

LIABILITY AND AUTHORIZATION