APPLICATION AND PERMIT FOR USE OF FACILITIES

Val Verde Unified School District

975 W. Morgan Street, Perris, CA 92571, (951) 940-6100

Application must be received by the M & O Dept. 10 working days prior to Scheduled Event or it may be denied.

FACILITY REQUESTED (School Name, Site or Facility Type) Today’s Date

Rancho Verde High School 12/26/2022

Description of Activity: Is FOOD being served? YES NO

Accommodation during Rose Bowl and Rose Parade activities, from Dec 27 If YES, exactly what is being served, who is
to Jan 4 providing the food, who is serving it?

APPLICANT: (Group or Individual) Outside Organization You Are Affiliated With:

Banda de Musica La Primavera None

Address (street, city, state, zip): Telephone Number and Email:
Santiago, Veraguas, Panama +1 626 200 5942
javierbamuslap@gmail.com
Building, Room, Grounds, Special Facilities Requested (APPLICANT):

Football field, band room and small gym, showers, restrooms and dressing rooms.
Building, Room, Grounds, Special Facilities Assigned ✔ MPR/Gym
(Site): Stadium
✔ Room # Music Room
✔ Field # 1
Room #
Field #
Other
Equipment and/or Set-up Requested ( Applicant): # of tables
# of chairs
Sound System
Mics
Other
Charges. If charges are to be incurred, the terms are:
1. 50% of fee payable with submission of application.
2. Balance seven days prior to use.
3. Payments made payable to Val Verde Unified School District. Failure to comply with the terms will be cause to deny
permission.
Is Custodial / Maintenance/Security Funding for Custodial/Maintenance/Security Overtime
Support Required:
YES NO Support Account Code: Unavailable
If NO for #11, please complete:
(a) Please explain who will open/close facility/site

(b) what site staff will be attendance and in charge of event for the duration of the event?
Dates Requested: Dec 27, 2022 to Jan 4, 2023

Hours of Use: From: 00:00 To: 12:00

Person in Charge of Event:

Javier Jiménez Ortiz

Make/Model/License of Vehicles to be On Premises:

School Bus #8 License number 8WZX150 , BUS #1 License number 8YUF453 School Bus #2 License number

Estimated Attendance:
200 people
Other Details relevant to Facility Use:
We will use the showers, restrooms and other rooms to change clothes and get dressed.

DECLARATION OF APPLICANT
1. The nature or type of intended use is:

2 . I, the applicant, have received or will receive for the activities herein listed contributions, cash collections, registration
fees,admission fees, tuition, donations, or other receipts estimated in the amount of $
If no receipts anticipated for these activities check here

3. Receipts set forth in item 2. above will be used for:

4. I, the undersigned, hereby certify that I will be personally responsible on behalf of the applicant for any damages
sustained by the school building, furniture, equipment, or grounds occurring through the occupancy or use of said
building and or grounds by the applicant, normal wear and tear excepted.

5. I hereby certify that I have received and read the rules, regulations, conditions and terms including those on the reverse
side of this application and that I and the applicant which I represent, will abide by them and will conform to all
applicable provisions of the Constitution and laws of California and to all other rules and regulations of the Board of
Education and its authorized agents which may be communicated to the applicant.

6. It is agreed that in the event this permit is canceled by the applicant no refund will be made and that changes in date or
extension of time shall be made only as specified by the rules governing use of school facilities.

7. In executing this declaration I certify that I have been duly authorized by the herein set forth applicant to act in its behalf in
making application for use of said facilities.

Applicant understands submission of application does not constitute automatic approval. Applicant understands that a
copy of application stamped APPROVED must be available at all times when using a Val Verde Unified School District
facility.
Signature of Applicant: Date:

Honglac Hathuc (Dec 26, 2022 00:05 EST)

12/26/2022
 SITE APPROVAL
SITE MANAGER APPROVES DISAPPROVES

Please explain if disapproved

Are Custodial Services Required: YES NO Name of Custodian:

MANAGER SIGNATURE:

DISTRICT OFFICE APPROVAL

D.O. MANAGER APPROVES DISAPPROVES

Please explain if disapproved

D.O. MANAGER SIGNATURE: Date:

  FOR OFFICE USE ONLY  

1. Insurance Required: 4 . Other Services:

Yes No Yes No

$1,000,000 Property/Liability with A Rating Describe:

2. Security for Event Required: (Required for 50+
Attendees)
Yes No

3. Office authorization for Custodial Services:

Yes No

Comments/Exceptions:

Schedule #:
APPLICATION EXPIRES JUNE 30, 2023
 Facility Use Insurance Document Submission

REQUIRED ITEMS MUST BE ATTACHED BEFORE YOU CAN SUBMIT THIS FORM:

• Is your site using a vendor or outsite organization?

o Yes No
• Does the Vendor have a completed VSA (Vendor Services Agreement)?
o Yes No
• Will food be served on-site
o Yes No
Additional Notes Regarding Request

Attach Completed VSA Agreement(s)

Attach COI Certificate(s) of Insurance with Additional Insured Endorsement

Attach Hold Harmless Agreement(s)

Attach Auto Insurance (if not included in COI)

Attach Food Handlers Certificate(s)

Once you have verified and checked all boxes, upload the documents, and
complete the signature process. You will receive a copy of the fully executed
agreement when it is signed by all required parties.

Office Use:

Submission of Documents Verified by:

 REPÚBLICA DE PANAMÁ
BANDA DE MÚSICA LA PRIMAVERA
ITINERARY
.
PANAMA GROUP – FLIGHT TO LOS ANGELES SCHEDULE
DECEMBER 27 AND DECEMBER 28

N° DEPARTURE ARRIVAL DATES

TIME TIME
PTY LAX
AIRPORT AIRPORT
GROUP 1 57 7:59 AM 12:19 PM 12/27/22
GROUP 2 63 6:58 PM 11:18 PM 12/27/22
GROUP 3 62 7:59 AM 12:19 PM 12/28/22
GROUP 4 44 11:50 AM 4:00 PM 12/28/22

PANAMA GROUP – FLIGHT TO PANAMA CITY SCHEDULE

N° NUMBER OF DEPARTURE ARRIVAL DATES OF DATES OF

PEOPLE PER TIME TIME DEPARTURE ARRIVE
FLIGHT LAX PTY FROM LAX TO
AIRPORT AIRPORT PANAMA

GROUP 1 57 12:54AM 10:23AM 1/2/23 1/3/23

GROUP 2 63 9:15 PM 6:44 AM 1/3/23 1/4/23
GROUP 3 62 12:54 AM 10:23 AM 1/3/23 1/4/23
GROUP 4 44 9:15PM 6:44 AM 1/4/23 1/5/23
DAY 1
BANDA DE MÚSICA LA PRIMAVERA (PANAMA)
ROSE PARADE 2023 ITINENARY
Time & Date Location & Activity Notes GOOGLE MAPS GPS LINK
SITES

Tuesday, Dec 27
Arrival to LAX AIRPORT
DAY 1
COPA AIRLINES TERMINAL NUMBER 3
ARRIVE GROUP 1 FROM PTY AIRPORT https://goo.gl/maps/RzHgrMH6eby
TO LAX ARRIVE TO BUS TRANSFER OF GROUP 1 WITH 57 PEOPLE THXbQ7 LAX TERMINAL 3
12:19 PM LAX AIRPORT TO RANCHO TO RANCHO VERDE HIGH SCHOOL
VERDE HIGH SCHOOL AT
MORENO VALLEY

ARRIVE GROUP 2 FROM PTY AIRPORT BUS TRANSFER OF GROUP 63 PEOPLE TO https://goo.gl/maps/RzHgrMH6eby
TO LAX ARRIVE TO RANCHO VERDE HIGH SCHOOL THXbQ7 LAX TERMINAL 3
11:18 PM LAX AIRPORT TO RANCHO
VERDE HIGH SCHOOL AT
MORENO VALLEY

RANCHO VERDE HIGH

SCHOOL
Wednesday, Dec 28 ARRIVAL TO LAX AIRPORT DAY 2
COPA AIRLINES TERMINAL NUMBER 3
Day 2
ARRIVE GROUP 3 FROM PTY AIRPORT https://goo.gl/maps/RzHgrMH6eby
TO LAX ARRIVE TO BUS TRANSFER OF GROUP 3 WITH 62 PEOPLE THXbQ7 LAX TERMINAL 3
12:19 PM LAX AIRPORT TO RANCHO TO RANCHO VERDE HIGH SCHOOL
VERDE HIGH SCHOOL AT
MORENO VALLEY

RANCHO VERDE HIGH

SCHOOL
ARRIVE GROUP 4 FROM PTY AIRPORT BUS TRANSFER OF GROUP 3 WITH 44 PEOPLE https://goo.gl/maps/RzHgrMH6eby
TO LAX ARRIVE TO TO RANCHO VERDE HIGH SCHOOL THXbQ7 LAX TERMINAL 3
4:00 PM LAX AIRPORT TO RANCHO
VERDE HIGH SCHOOL AT
MORENO VALLEY
 BANDA DE MÚSICA LA PRIMAVERA (PANAMA)
ROSE PARADE 2023 ITINENARY
Time & Date Location & Activity No GOOGLE MAPS GPS
tes LINK SITES
Thursday, Dec 29 LOS ANGELES CITY TOUR
HIGWAY
TRAVEL DAY 3
BUS TIME
DAY 3 8:30 A.M 1 HOUR 10 9:40 DEPARTURE OF THE 4 BUSES From Rancho Verde THE 4 BUSES MUST PARKING AT CHEVRON GAS or Summit
MINUTES A:M High School to Summit Inn Sign at Hesperia, CA 92344, inn sign parking, https://goo.gl/maps/qCj8fY6PLkc7
Estados Unidos. STATION. The ADDRESS IS UgrS9
Chevron CHEVRON GAS STATION
DEPARTURE OF RANCHO VERDE HIGH SCHOOL: 8:30
6000 Mariposa Rd, Hesperia, CA 92344, Estados AT MARIPOSA ROAD,
A.M.
HESPERIA, CA.
ARRIVE TO SUMMIT INN SIGN: 9:40 A.M.
SUMMIT INN SIGN
TIME OF WALK IN SNOW PLACE: 45 MINUTES Hesperia, CA 92344
https://goo.gl/maps/TcE6a98B6WY
P.D. THIS PLACE IS SO SPECIAL FOR OUR
DELEGATION FOR THAT WE CAN VISIT AND MEET eo5we6
THE SNOW FREE PLACE FOR FIRST TIME
10:25 A.M. 1 HOUR 34 12:00 DEPARTURE OF THE 4 BUSES From Summit Inn Sign at
MINUTES P.M. Hesperia TO GRIFFITH Observatory.
DEPARTURE OS SUMMIT INN SIGN: 10:25 A.M.
ARRIVE TO GRIFFITH OBS.: 12:00 P.M

TIME OF WALK INGRIFFITH OBS.: 1 HOUR WITH 30

MINUTES
1:30 P.M. 15 1:45 DEPARTURE OF THE 4 BUSES From GRIFFITH
MINUTES P.M. Observatory.TO Hollywood Walk of Fame.
DEPARTURE OF GRIFFITH OBS.: 1:30 P.M.
ARRIVE TO HOLLYWOOD: 1:45 P.M

TIME OF WALK IN HOLLYWOOD: 3 HOURS

1 HOUR 5:45 DEPARTURE OF THE 4 BUSES From
4:45 P.M. P.M HOLLYWOOD WALK OF FAME TO SANTA MONICA
PIER

DEPARTURE OF HOLLYWOOD: 4:45 P.M

ARRIVE TO SANTA MONICA PIER: 5:45 P.M.
TIME OF WALK IN SANTA MONICA: 3 HOURS
8:45: P.M. 1 HOUR 9:45 DEPARTURE OF THE 4 BUSES FROM SANTA MONICA
PM pier TO Rancho Verde High School at Anaheim

6:00 PM 8:30 Drive to Rancho Verde High School

PM
 BANDA DE MÚSICA LA PRIMAVERA (PANAMA)
ROSE PARADE 2023 ITINENARY
DAY 4
Time & Date Location & Activity N GOOGLE MAPS GPS LINK SITES
o
t
e
s

Friday, Dec 30
Practice day at RanchoVERDE HIGH
SChOOL
DAY 4

DAY 5
Saturday, Dec 31

HIGWAY
TRAVEL
BANDA DE MUSICA LA PRIMAVERA (
PANAMA ) BANDFEST PERFORMANCE
DAY 5
BUS
TIME AT PASADENA CITY COLLEGE
5:00 A.M. 1 HOUR 6 :00 DEPARTURE OF RANCHO VERDE HIGH
A.M. SCHOOL AT ANAHEIM to ROSE BOWL
STADIUM
1:00 1 Hour 2:00 DEPARTURE FROM PASADENA CITY https://goo.gl/maps/KDDdLNt4iADg
COLLEGE PARKING LOT HILL & DEL MAR mkRo8
TO ROSE BOWL
196-228 S Hill Ave, Pasadena, CA
91106, Estados Unidos
5 00 6 00 PM DEPARTURE OF ROSE BOWL STADIUM
TO RANCHO VERDE HIGH SCHOOL
DAY 6

Time & Date Location & Activity Notes MAPS SITE LINKS
Shopping Day AT CITADEL OUTLETS
Sunday, Jan 1st MALL DAY 6
HIGWAY
TRAVEL
BUS TIME
9:00 45 9:45 DEPARTURE FROM RANCHO
Minutes VERDE HIGH SCHOOL TO CITADEL
OULETS
DEPARTURE TIME 9:00 A.M.
ARRIVAL TIME: 9:50 A.M.
6:00 45 Minutes 6:45 DEPARTURE FROM CITADEL OUTLETS
TO RANCHO VERDE HIGH SCHOO

Monday, January 2 DAY 7

DAY 7 ROSE PARADE DAY
HIGWAY
TRAVEL
BUS TIME
1:50 1 HOUR 2:50 A.M DEPARTURE FROM DEPARTURE WE MUST ARRIVE TO W DEL MAR BRIDGE TO WEST DEL MARD
A.M. FROM RANCHO VERDE HIGH SCHOOL 3:00 A.M. BOULEVARD BRIDGE
TO WEST DEL MAR BOULEVARD
BRIDGE AT PASADENA https://goo.gl/maps/A57JQ4
LQ8ZmXFfoq5
THE BUSES MUST GO TO End of
Parade Disbanding Area at Paloma
Street. Waiting the Band for return to
Rancho Verde High School
1:00 P.M 1 hour 2:00 P.M. DEPARTURE FROM Paloma Street. Near PALOMA STREET
of Pasadena High School. ( END OF ROSE
PARADE ROUTE TO RANCHO VERDE https://goo.gl/maps/DF9N4F
HIGH SCHOOL 7ADfFStc3p6
MONDAY JANUARY 2 ON RETURN OF THE FIRST GROUP TO
NIGHT. PANAMA ON MONDAY 2 on NIGHT
HIGWAY DEPARTURE COPA AIRLINES TERMINAL NUMBER 3
TRAVEL
BUS TIME TIME
LAX
AIRPORT TO PANAMA
12:54AM
5:00 45 7:00 P.M DEPARTURE OF RANCHO VERDE BUS TRANSFER OF GROUP 1 WITH 57 PEOPLE
P.M., MINUTES HIGH SCHOOL TO LAX AIRPORT . TO LAX AIPORT
DEPARTURE OF RANCHO VERDE
HIGH SCOOL :
5:00 P.M. DEPARTURE COPA AIRLINES FLIGHT
ARRIVE TO LAX AIRPORT 7:00 P.M. TO PANAMA 12:54 AM ON JANUARY 2
DAY 8
Tuesday, Jan 3 RETURN OF SECOND AND THIRD GROUP
TO PANAMA
DAY 8
HIGWAY COPA AIRLINES TERMINAL NUMBER 3
TRAVEL
BUS
TIME
2:00 P.M. 1 Hour 4:00 DEPARTURE OF RANCHO VERDE HIGH BUS TRANSFER OF GROUP 2 WITH 63 PEOPLE
2 Hour P.M SCHOOL TO LAX AIRPORT . TO LAX AIRPORT
with
Heavy
DEPARTURE OF RANCHO VERDE HIG DEPARTURE COPA AIRLINES FLIGHT TO PANAMA
Traffic SCHOOL:2:00 P.M.
9:15 PM ON JANUARY 3
ARRIVE TO LAX AIRPORT 4:00 P.M.
THINKING ON TRAFFIC

BUS TRANSFER OF GROUP 2 WITH 62 PEOPLE

1 Hour TO LAX AIRPORT
2 Hour
DEPARTURE OF RANCHO VERDE
with
HIGH SCHOOL:4:30 P.M.
Heavy
Traffic ARRIVE TO LAX AIRPORT 6:30 P.M. DEPARTURE COPA AIRLINES FLIGHT TO PANAMA
THINKING ON TRAFFIC
12:54 AM ON JANUARY 3
DAY 9

Thursday, Jan 4 RETURN OF FOURTH- FINAL GROUP TO

PANAMA
DAY 9
HIGWAY COPA AIRLINES TERMINAL NUMBER 3
TRAVEL
BUS
TIME
2:00 P.M. 1 Hour 4:00 DEPARTURE OF RANCHO VERDE HIGH BUS TRANSFER OF GROUP 4 WITH 44 PEOPLE
2 Hour P.M. SCHOOL TO LAX AIRPORT . TO LAX AIRPORT
with
Heavy
DEPARTURE OF RANCHO VERDE DEPARTURE COPA AIRLINES FLIGHT TO PANAMA
Traffic
HIGH SCHOOL:2:00 P.M.
9:15 PM ON JANUARY 4
ARRIVE TO LAX AIRPORT 4:00 P.M.
THINKING ON TRAFFIC