Lesley Zerebny Park form (PDF)
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Author: Gustavo Bermeo
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NAMING OF DISTRICT FACILITIES SUGGESTION FORM
“Exchange Club Park” Project in Valle Vista
Lesley Zerebny Memorial Park
Name for Consideration: __________________________________________________________
All fully completed forms will be reviewed by the Valley-Wide Board of Directors and
considered in determining the facility name.
The Facility may be named after the region and/or individual or individuals who have
been instrumental in the community.
Description of the significance and/or reason for the name consideration:
(Please print or type comments. No cursive)
________________________________________________________________________________________
For bravely continuing the legacy of Public Service, by committing herself to the honorable profession of Law
________________________________________________________________________________________
Enforcement, who lost her life while servicing the community she was sworn to protect.
________________________________________________________________________________________
End of Watch, Ocotober 8th 2016, armed with the sword of her spirit. May the park serve as an everlasting
________________________________________________________________________________________
memory of her dedication, a tribute to all that have served, and an inspiration for others to follow.
________________________________________________________________________________________
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________________________________________________________________________________________
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Submitted By:
Name (please print) _____________________________________________________________________________
Address ___________________________________________________________________________________________
Phone Number: _____________________________ Email: _____________________________________________
Signature: ________________________________________________ Date: _________________________________
PLEASE SUBMIT COMPLETED FORMS TO THE VALLE VISTA COMMUNITY CENTER (43935 E. ACACIA
AVE. HEMET, CA 92544) ) NO LATER THAN OCTOBER 14. 2016.
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