Date Requested. Times Requested: Setup Time: Room(s) requested: Number of People Attending: List of Amenities Requested (ie. Kitchen, podium, etc.): Applicant Signature: Date: , 20 Staff Signature: Date: , 20 Any check returned for insufficient funds or on which payment has been stopped will result in automatic cancellation of the Community Center Facilities Agreement and will be charged a $25 service fee. Please submit fees, completed Community Center Facilities Agreement, Floor plan, and Waiver to: West Hanover Parks & Recreation - 000 Xxxxxx Xxxxxx, Xxxxxxxxxx, XX. 00000. Date Paid: Rental Fee + Amenities: Discount: Total: Security Deposit: Total Amount Due: Payment Information: Cash Credit Card Check # Payment Amount: Amount Due: (This amount due 30 days prior to rental) I hereby apply to the Township of West Hanover to rent and use the facility, or facilities as mention in the attached agreement, for a private and/or public function during the time frame of (date), I understand that by renting this or these facilities I will expose myself and my guests to normal risks of injury or harm associated with nature, events, classes, meetings and activities. I agree that I am responsible for my own safety. I agree to abide by all rules and regulations in regards to the Community Center use. I agree that I am responsible for my guest’s safety to the point of producing a safe event or activity during the length of this contract. I hereby assume all risk and responsibility of damage to the property of the Township of West Hanover as it relates to my event and my use and/or misuse; and hold the Township of West Hanover, its agents and representatives harmless for any and all suits relating to the use of Township owned facilities. I hereby agree to protect, indemnify, save, keep, and hold harmless the Township of West Hanover, its elected and/or appointed officials, its agents, servants and employees, against and from any and all claims, causes of action or liability, loss, damage or expense, brought by me or on my behalf or by my guests or on their behalf, arising out of the use of the Township facilities and the activities conducted therein or thereon for which I have made application to the Township to use for a public and/or private function. I agree that this Release and Waiver shall be construed and interpreted according to the law of the State of Pennsylvania. I understand and agree that this Release and Waiver shall be binding upon my heirs, assigns and any personal entit...
Date Requested. Time Requested: open: close: No one will be allowed in the pool area until 6:00 pm. You are responsible for any and all clean up including but not limited to; garbage, decorations, tables etc. You must be cleaned up by the time that you agreed to in your pool use agreement. Approximate number of quest expected: 200 and up Wading Pool w/ Main Pool Small Blue Slide Bowl Slide Wading Pool Only 4 Total # of Staff X $12.50/Hour X Number of Hours = Total Staff Cost: $ Signature of Applicant/Date Agent, Genoa Township Park District/Date Date Deposit Received Amount Cash/Check # Date Rental Fee Received Cash/Check # Amount This is an agreement between the Genoa Township Park District and the “responsible party” for the use of the fa- cilities in Xxxxxxxxxxx Park, 000 Xxxx Xxxxxx Xxxxxx xx Xxxxx, Xx. We the aforementioned do hereby agree to the following terms and conditions as set forth by the Genoa Township Park District. These regulations are to be fol- lowed to assure their refund of the responsible party's deposit. Responsible Party: _
Date Requested. Hours Requested:
Examples of Date Requested in a sentence
Xxxxx, Governor Xxxxxxx Xxxxxxx, Commissioner NYSDOT XXXX XXXXXXX, DQAB PS&E UNIT NYSDOT POD 23 00 XXXX XXXX ALBANY NY 12232 Schedule Year 2019 Date Requested 07/26/2019 PRC# 2019009744 Location Queens Project ID# D900048 Project Type Replacement of bridges; Retrofit of bridges; Intersection improvements to ensure ADA compliance; Replacement and upgrade of traffic signals; Relocation of two ramps.
Project Name or Title: Expected Completion Date: Requested CDBG Funds: $ Organizational Match: $ Funds from Other Sources: $ Total Project Cost: $ Application Contents A complete proposal shall include a brief narrative summary on applicant letterhead, full project cost, all federal, state and local subsidies requested for the project, proposed ownership entity, phone number and mailing address of contact person for the designated non-profit or certified Community Housing Development Organization.
Any items that not covered in Server Hardware Description may be included in future subject to agreement of Both Parties.
Today's Date Date Requested for Personal Leave No more than six (6) certified employees (3 per building) may utilize personal leave on the same day.
Admission Date Requested Student’s Name Date of Birth Current Grade Level Name and Address of Present School Principal’s Name Principal’s Phone Number 1.
More Definitions of Date Requested
Date Requested. HOW REQUESTED: PHONE LETTER FAX OTHER
Date Requested. Hours Requested: Day of Week: Total Expected Attendance: Is this group based within the Morton Park District? Yes ( ) No ( ) Do you understand that Morton Park District requires a separate, approved agreement for rentals that will involve consumption or possession of alcohol at The Barn at Bull Run? Yes ( ) No ( )
Date Requested. Hours Requested: Number Expected to Attend: Title of Event
Date Requested. Day of Week: Type of Activity: Starting Field Time: am/pm TO Ending Field Time: am/pm Name of Applicant: Phone Number: Name of Organization: State Non-Profit ID# Designated Person In Charge on the Day of Event: Phone: Address: City: Zip: Cell Phone: Email: Children (ages 1-12) Teens (ages 13-20) Adults (ages 21-35) Adults (ages 35+) My signature certifies I have read and understood the Sports Field Rental Policy and Rental Agreement as set forth by the City of San Pablo governing the use of Public Fields. I take full responsibility for ensuring the use of this facility and areas by the organization/party I represent is in full adherence and compliance with these rules and regulations. I understand I assume full responsibility for any penalty fees assessed by the City of San Pablo for any violations of these rules and regulations governing the use of the above requested field. I am aware my Deposit is non-refundable if I cancel within 2-weeks of my reservation for any reason. I am also aware that by signing this contract, I take full responsibility for the behavior exhibited by my guests during my rental.
Date Requested. Facility/Shelter:
Date Requested. Hours Requested: Day of Week: Total Expected Attendance: This Organization is a: Civic ( ) Religious ( ) School ( ) Charity ( ) Service ( ) Commercial ( ) Private ( ) Other ( ) explain: Is this group based within the Morton Park District? Yes ( ) No ( ) If yes, approximately what percentage of the membership resides within the boundaries of the Morton Park District? Do you understand that Morton Park District Ordinance PROHIBITS the consumption or possession of alcohol at all parks? Yes ( ) No ( ) Will there be admission charged or merchandise sold? Yes ( ) No ( ) If yes, please explain how proceeds will be used: (A refundable damage and clean-up deposit of $50.00 is required for ALL rentals. Depositors forfeit $25.00 of the deposit if rental is cancelled.)
Date Requested. Start Time: End Time: Set-up Time: Frequency: One time Monthly Weekly Other Which Day of the Week: Monday Tuesday Wednesday Thursday Friday Sat Sun Describe in detail the type of event you will be bringing to our facility, including the number of participants. Will food or drink be consumed? Yes No Number of table and chairs needed: Will you need a sound technician? Yes No Will you need childcare? Yes No Will your event be outside office hours? Yes No Name and contact for your greeters: South Entrance Doors North Entrance Doors Phone number: Will your event be canceled due to inclement weather? Yes No Is this a First Baptist Church of Cadillac function? Yes No If yes, will you need printed communication? Yes No Is your group a Nonprofit 501 (c) 3 Organization: Yes No Nonprofit Tax ID number: Please list in detail the set-up requirements necessary for your event. Provide a diagram if possible.