Facility Rental Agreement

DO NOT fill out form and make payment if you have not scheduled a party date and time with admin staff at The Shack Neighborhood House.

MUST READ document before filling out Facility Rental Agreement Form.

Shack Neighborhood House Rules, Policies and Procedures
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Facility Rental Agreement

The total cost of a 2 hour private party rental is $110.00 for (60 individuals) Additional fees for parties greater than 60 individuals. We require a $50.00 deposit to confirm your scheduled party date. The remaining $60.00 balance is due the day of the event. All checks are to be made payable to The Shack Neighborhood House Inc. When using a check for payment, you agree to the following terms: In the event your check is dishonored or returned for any reason, you authorize The Shack Neighborhood House Inc. to electronically (or by paper draft) re-present the check to the bank account for collection of the check amount, plus any applicable fees as permitted by state law. $25.00 refund fee for party cancellation.

Please fill out the following form completely, add your digital signature, and make your deposit or full payment on the next page.

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Date & Time Understanding Statement *

I understand that I MUST contact admin staff at The Shack Neighborhood House and schedule a time by phone before filling out this form and recording date and time below. Filling out form and making payment without prior scheduled party date & time could result in a $25 refund fee if refund is assessed.

Month *

Day *

Year *

Time *

Payment Method *

Please Note: Payment not made within two weeks from the date on your email could result in a party cancellation.

Each box MUST be check marked that you understand and agree to the terms and a full name electronic signature or the party may be cancelled.

Must check each box. *

The undersigned hereby assumes personal and individual liability of himself/herself and on behalf of Applicant for any damages to the facility or equipment occurring through or during occupancy or use of the facility by the Applicant. The undersigned will leave the facility in a condition as good as, or better than, originally found. The undersigned personally and individually on the behalf of the applicant accepts liability for all repairs to the facility and/or repair or replacement of any equipment in the event of damage.

Choose Any *

In the event that you and/or your guest are unable to adhere to the above stated guidelines, you will be charged additional rental fee and/or asked to vacate the premises by the facility staff and/or the police department. By signing below, the applicant acknowledges that he/she is responsible for ensuring that all guests adhere to the above rules and will provide payment for the use of the facility by the assigned date.

Choose Any *

I/We agree to defend, indemnify, and hold harmless The Shack Neighborhood House Inc., its employees, board of directors, and volunteers from any claims, demands, suits, losses, costs, or expenses. Including attorney fees, or any damages which may be asserted claimed or recovered against or from The Shack Neighborhood House Inc. by reason of any damaged property, personal injury, or bodily injury, including death, sustained by any person whomsoever and which damage, injury, or death arises out of or is incident to or in any way connected with the performance of this contract, excepting however, claims arising from the sole unequivocal negligence of The Shack Neighborhood House Inc.

Choose Any *

I have opened, read and understand the rules outlined on the Rules, Policies and Procedures document above.

Choose Any *

I understand that I will be charged a $5.00 convenience fee to use the online payment services. This convenience fee is not considered part of the total payment of the party.

Electronic Signature - Please note: By typing your full name in the text box below, you are accepting all of the above terms of this Facility Rental Agreement. *

I agree to receiving marketing and promotional materials

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