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2. Today's Date (MM/DD/YY)*
4. Subject of Event (ie. Birthday Party or Workshop)*
6. Reserved Date (MM/DD/YY)*
8. Location(s):
   *
   -- Select One --Carriage HouseMain House Pavilion
10. Number of Guests*
12. Set-Up Time (ie. 10:00am)*
14. Departure Time ( ie. 11:00pm)
    **departure time is after clean up has been completed***
16. Permit Holder Name*
18. Address*
20. City, State, and Zip Code*
22. Phone Number (ie. 650-752-0500)*
24. Email Address*
26. Caterer (Name)
28. Caterer Phone Number
30. Proof of liability insurance is required. The permit holder/organization must furnish a certificate of insurance proving liability coverage of at least $1,000,000.00 naming the Town of Atherton as additional insured. The certificate should read as follows: Town of Atherton, Holbrook-Palmer Park, 150 Watkins Avenue, Atherton, CA 94027.
    Insurance can be purchased through the Town’s Special Events Insurance Program.
    
32. LIABILITY INSURANCE FROM CATERER OR ANY VENDOR: Proof of liability insurance is required. The caterer or any additional vendor must furnish a certificate of insurance proving liability coverage of at least $1,000,000.00 naming the Town of Atherton as additional insured. The certificate should read as follows: Town of Atherton, Holbrook-Palmer Park, 150 Watkins Avenue, Atherton, CA 94027. This insurance must cover everyone working the event and read "its officers, agents, and employees". Note - if serving liquor, liquor liability coverage is needed from the catering group or bartender. There will be a separate limit for Liquor Liability of $1,000,000.00. The Town and the applicant renting/using the park must be named on the vendor's policy as an additional insured.
34. ALL CANCELLATIONS OR CHANGES MUST BE SUBMITTED IN WRITING:
    6 months before reservation date 10% of total fees and deposit will be charged
    3 – 6 months before reservation date 20% of total fees and deposit will be charged
    1 – 3 months before reservation date 30% of total fees and deposit will be charged
    Less than 1 month before reservation date 40% of total fees and deposit will be charged
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35. Submit

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