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[null,"施　設　使　用　申　請　書"]
[{"$nulls":19},"令和　　　　　年　　　　　月　　　　　日"]
[null,"　特定非営利活動法人　きらり鏡野　　　殿"]
[]
[{"$nulls":6},"下記のとおり施設を使用したいので、申請します。"]
[{"$nulls":6},"なお、使用については、各種施設に関する使用規則に既定する使用条件を守ります。"]
[]
[null,"記"]
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[null,"使用者",null,null,"住　　所",{"$nulls":13},"TEL",null,"（　          　）　  　－　"]
[{"$nulls":18},"携帯",null,"　　　　　－　　　　　　　－"]
[{"$nulls":4},"団体名",{"$nulls":9},"使用人数合計",null,null,"町内",null,"一般",null,null,null,"高校生以下"]
[{"$nulls":22},"人",null,null,null,"人"]
[{"$nulls":4},"代表者氏名",{"$nulls":12},"町外",null,"一般",null,null,null,"高校生以下"]
[{"$nulls":16},"人",{"$nulls":5},"人",null,null,null,"人"]
[null,"使用日時",null,null,"令和",null,"年",null,"月",null,"日",null,"曜日",null,null,null,"時　",null,"分","～",null,"時",null,"分"]
[null,"使用施設",null,null,"　１．　文化スポーツセンター",{"$nulls":11},"　４．　町民グラウンド　（　野球場　　・　　サブグラウンド　）"]
[{"$nulls":5},"・","アリーナ",null,null,"(全面）　（１/２）　（１/４）　"]
[{"$nulls":5},"・","アリーナ照明",{"$nulls":9},"　５．　スポーツロッジ　（　宿泊　・　休憩　）"]
[{"$nulls":5},"・","ステージ",null,null,"・","ステージ照明",{"$nulls":6},"　　　月　　　日　　　曜日　　　時　　分～"]
[{"$nulls":5},"・","放送設備",{"$nulls":12},"　　　月　　　日　　　曜日　　　時　　分まで"]
[{"$nulls":5},"・","研修室",null,null,"冷暖房使用時間（　　　　　時間）",{"$nulls":7},"中学生以下",null,null,null,"人"]
[{"$nulls":5},"・","トレーニング室",null,null,"冷暖房使用時間（　　　　　時間）",{"$nulls":7},"高校・大学生　",null,null,null,"人"]
[{"$nulls":4},"　２．　鏡野ドーム",{"$nulls":12},"一　　　　 般",null,null,null,"人"]
[{"$nulls":5},"(全面）　（１/２）",{"$nulls":10},"　６．　テニスコート　（　　　　　　　　　　）"]
[{"$nulls":5},"・","ドーム照明",null,null,"(全面）　（１/２）　",{"$nulls":7},"・","照明　（60分　　　　枚　　・　　120分　　　　枚）"]
[{"$nulls":4},"　３．　駐車場　（　　　　　　　　　　　　　　　）",{"$nulls":11},"　7．　鏡野ふれあい運動公園"]
[null,"使用目的"]
[null,"会場使用料",{"$nulls":6},"照明・冷暖房",{"$nulls":6},"合計",{"$nulls":6},"領収　　　・　　　未収"]
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[null,null,"＊","使用者の責に帰すべき理由により館具・建物・器具を破損もくは亡失した場合は、それによって生じた損害を賠償しなければならない。"]
[null,null,"＊","使用後は直ちに清掃し、現状に復し管理者に届けること。"]
[null,null,"＊","使用時間は厳守とし（準備・清掃の時間を含む）、特に火気の取り扱いについては十分注意すること。"]