Juanita Pohl Center Sponsorship Interest Form

The undersigned applicant, by signature below, shall hold harmless the City of Tualatin, its officers, agents, and employees and shall indemnify and, if requested, defend the City, its officers, agents, and employees for any claim or injury to property or persons that may arise as a result of any activity which may arise from operations under or in connection with the permit.

I do affirm that the foregoing statements and representations are binding upon me, or if executed on behalf of a Sponsoring Entity, are binding upon the Sponsor and are executed pursuant to authority. The information submitted is true to the best knowledge of the undersigned, and the undersigned shall notify City in writing at any time as additional information is known or the plans for the event are revised  which would alter the information and statements given.

SIGNATURE:

The undersigned affirms that they are an authorized representative of the applicant with authority to execute this application.