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Big
Chico Creek Ecological Reserve
Request for Use Permit
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and Mail (Click
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Applicant
Name: _______________________________________________
Full Address and Zip: _________________________________________________________________________
Phone Number: ____________________
Email Address: ________________________________________________
Emergency Contact: ____________________________________________
Vehicle License Plate: ___________________________________________
Type of use: Research
Education Nature Study Other (specify)_____________________
Requested date and time
of use:____________________________________
Number of individuals in
group: ____________________________________
Group name:__________________________________________________
(Sponsoring groups must remit proof of insurance with
request. )
Additional Comments (if
any): ____________________________________
_____________________________________________________________
The applicant confirms
he/ she has read and understands the Big
Chico Creek Ecological Reserve's "Use Guidelines" and will
adhere to all rules and regulations.The
applicant will hold harmless the California State University Chico, Research
Foundation for
any
and all injuries or loss occurring or arising in any manner whatsoever by reason
of his/her presence on the Big Chico Creek Ecological Reserve in Butte Co.,
California.
Signed: _______________________________________________________
Print
and Mail to:
Ecological Reserves
California State University, Chico
Chico, CA 95929-0215
Big Chico Creek Ecological Reserve
California State University, Chico
400 West First Street
Chico, CA 95929-0215
Phone: 530-898-5010 |