Form Center

2. Application Date*
   Application Date
4. Are you submitting this Partnership Application as an individual or representative of an organization?*
   -- Select One --IndividualOrganization
6. Organization Name*
8. Main Contact Name*

   First and Last Name

9. Main Contact Email Address*
11. Address of Individual or Organization*
13. City*
14. State*
15. Zip Code*
17. Phone Number*
19. Is Organization a Non-Profit?*
    -- Select One --YesNo

    This is not a requirement for partnership with the District.

21. Proof of Non-Profit Status*

    Upload a file. Acceptable file types include: .pdf, .gif, .jpg, .jpeg, .png, .svg, .tif, .tiff

    Please upload proof of government issued documentation of non-profit tax-exempt status (i.e. State Letter).

23. Website
25. Organization Phone Number*

27. All eligible persons and organizations ("Applicant") wishing to enter into a Partnership with the Cosumnes Community Services District ("District") must submit an application to, and receive approval from, the District no less than thirty (30) days prior to term start date of the Partnership Agreement.

29. District Mission, Vision, and Goals

    Mission: The Cosumnes CSD is dedicated to enhancing the quality of life of the residents, businesses, visitors, and employees within our diverse community by protecting lives, property, and the environment through superior fire suppression, emergency medical services, fire prevention and special operations response; and by providing parks and recreation services through well-maintained parks and recreational opportunities for health, wellness, and social interactions.

    Vision: Be an innovative, inclusive, and intentional, regional leader committed to providing exceptional services that exceed expectations and enhance the quality of life of those we serve.

    Goals:

    Meeting the Needs of Our Growing Community

    • Create responsive programs, parks, and facilities for Elk Grove's diverse and growing community.

    Revitalization and Developing Community Spaces

    • Strengthen parks and recreation facilities for future generations.

    Enhancing Community Connections

    • Foster collaborative partnerships that leverage strengths and resources to enhance recreation experiences.

    Ensuring a Sustainable Parks and Recreation System

    • Allocate staff and resources based in sound operational practices to ensure long-term operation and maintainability.
31. Please explain how your proposed partnership aligns with the District's Mission, Vision, and Goals*
33. Overview of your Event/ Activity*

    Please provide a detailed description of the Partnership support requested. For example: Type of event/activity, what happens during event//activity, who is served by the event/activity, etc.

35. Partnership Type Requested*

    Please check all that apply.

    1. Facility Use for Private Event/ Meeting (e.g. Community Organization quarterly meeting)
    2. District Support for Community Event
    3. Other
37. Requested Location(s)*
39. Facility Use Start Date/Time*
    Facility Use Start Date/Time

    Facility Use Start Date/Time

    Please include prep time

40. Facility Use End Date/Time*
    Facility Use End Date/Time

    Facility Use End Date/Time

    Please include clean up time

42. Date/Time of Event*
    Date/Time of Event

    Please include prep and clean up time

43. Start Time*
    Start Time
44. End Time*
    End Time
46. Start Date of Event*
    Start Date of Event
47. End Date of Event*
    End Date of Event
48. Start Time for Event(s)*
    Start Time for Event(s) Start Time

    —

    Start Time for Event(s) End Time

    Please include prep and clean up time

51. Please list all dates requested for Event

    If not specific dates, please provide details about month(s), frequency, etc.

53. Day(s) of the Week Requested

    1. Sunday
    2. Monday
    3. Tuesday
    4. Wednesday
    5. Thursday
    6. Friday
    7. Saturday

    Please check all that apply

55. Proposed Timeframe for Event(s)
    Proposed Timeframe for Event(s) Start Time

    —

    Proposed Timeframe for Event(s) End Time
57. Event Name*
59. Other Type
61. Equitable Trade*

    1. Volunteer Hours and/or Event Support
    2. Revenue/ Donation
    3. Facilitation of Activity/ Event for Community
    4. Facilitation of Education/ Training for Community and/or District Staff
    5. Other

    Please indicate the type(s) of equitable trade that you are proposing as part of the terms of Equitable Partnership Agreement.

63. Equitable Trade- Other*

    Please provide detailed information.

65. Terms and Conditions

    Eligibility: The following criteria must be met in order to be considered for Partnership Agreement:

    • District Support as outlined in Partnership Agreement must be in line with the District's mission, vision, and goals.
    • Fundraising events will be considered if the event benefits a non-profit that serves primarily Elk Grove Residents.
    • Events or activities that discriminate on the grounds of race, color, national origin, ancestry, age, gender, ability, sexual orientation, gender identity, gender expression, military status and/or religion will NOT be eligible.

    Insurance: If required by terms of Partnership Agreement, applicant must provide a certificate of insurance that provides general minimum coverage of  $1,000,000 per occurrence, $2,000,000 aggregate naming the Cosumnes Community Services District, its directors, agents, and employees as additionally insured no less than one week prior to the term start date of Partnership Agreement.

67. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, 3) you may still be required to provide a traditional signature at a later date, and 4) I understand that my application for Partnership is not final or approved until I am contacted by a District representative, and a Partnership Agreement is signed and fully executed. I attest that all the information on this application is true and correct.

    Falsification of your application, of any kind, will cause cancellation of the Agreement and forfeiture of any fees and deposits.

    1. I agree.
69. Electronic Signature*
Leave This Blank:


72. 1. Receive an email copy of this form.
73. Email address

    This field is not part of the form submission.

74. Submit

* indicates a required field