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7 EXHIBIT A (Application for Use: Gymnasium) Application for Use: Gymnasium City of Pleasanton Library and Recreation Department Mailing Address P.O. Box 520, Pleasanton, CA 94566 Phone: (925) 931 -3437 Applicant Name: Organization Name: Applicant Phone: Organization Phone: Applicant Email: Organization Website: Applicant Address: Organization Address: Estimated Number of Participants: What percent of group are Pleasanton residents? Brief Explanation of Sport/Activity and Equipment List (i.e. games, practices, clinics, vendors, amplified sound, tents, etc.): Dates (actual dates of use may vary from dates requested): Times (actual times of use may vary from times requested): Location & number of Gyms*(actual gym lo cation may vary from gym requested): *Pleasanton Middle School (PMS) and Harvest Park Middle School (HP) have 1 or 2 courts. Thomas Hart Middle School (Hart) only has 1 court. 1 Court = 1 Full Size Basketball Court or 2 Volleyball Courts 2 Court = 2 Full Size Basketball Courts or 4 Volleyball Courts I certify that the information provided herein is correct. If I am renting the facility on behalf of an organization, I certify that I am authorized to execute this agreement on behalf of the organization. I certify that I have read the Rules and Regulations (“Rules”) at www.pleasantonsports.org pertaining to the use of the City’s facility. I agree to comply with the Rules and to be responsible for informing those using the facility of the Rules. I agree (and/or the organization that is seeking to use the facility agrees) to be responsible for any damage sustained to the facility as a result of my use (or my organization’s use) of the facility. I further agree (and/or the organization that is seeking to use the facility agrees) to release, hold harmless, defend, and i ndemnify the City of Pleasanton from any claim, damages, injuries or death, costs, or cause of action which I have (or may have in the future) related to use of the facility. I have provided the City with a Certificate of Liability Insurance with a minimum general liability limit of $2,000,000 per o ccurrence and an Additional Insured Endorsement naming the following as additional insured: the City of Pleasanton, its officers, employees, agents, and volunteers (and where the facility is owned by the District also naming the Pleasanton Unified School District, its offic ers, employees, agents, and volunteers.) Signature of Applicant Date: FOR OFFICE USE ONLY Recreation: Approved: Not Approved: Docusign Envelope ID: 24C002DB-26FC-4B11-90E4-6D5F84818FC7