RENTAL APPLICATION

East Berlin Area Community Center

405 North Avenue   P.O.Box 530   East Berlin, PA 17316 

(Office) 717-259-8848   (Fax) 717-259-0149   www.ebacc.com

       

Event Date ____________________________________ Time ______________ to ______________________

 

Space(s) requested:

˙ Pavilion    ˙ Ball Field   ˙ Gym    ˙ Senior Center    ˙ Room 4    ˙ 1A    ˙ 1D    ˙ 2A    ˙ 2D   

 

Organization/Person making request ____________________________________________________________

 

Address ____________________________________________________ Home Phone____________________

 

___________________________________________________________ Work Phone_____________________

 

Purpose of rental ____________________________________________________________________________

 

Number of guests/participants (approx.) _________________________________________________________

 

Will you need tables and chairs?     ˙ Yes     ˙ No    # of tables ______________ # of chairs ________________

 

Will you need tables and chairs set-up by EBACC staff?  (Additional Charge)     ˙ Yes     ˙ No

 

Will there be an admission fee charged at your event?     ˙Yes     ˙ No

 

Organization/individual agreement to adhere to rules and regulations:

a)        Security deposit due upon signing and to be deducted from balance due. 

b)       Balance due seven (7) days before event.

c)        Deposit will be forfeited if area rented is not cleaned and arranged in the same order as found.

d)       Applicant is responsible for any damages that may occur to EBACC property.

e)        Reservations for which the balance has not been received are subject to cancellation and deposit forfeited.

f)        No refunds will be made for no-shows.                    

g)        No alcoholic beverages or smoking is allowed in the community center.                    

h)       Bagged garbage must be taken away from the community center property.            

i)         EBACC is not responsible for any injuries that may occur to guests during the use of the center/property.

j)         Sports associations must provide Certificate of Insurance (commercial) prior to start of practices/games.

k)       All sports participants must be covered by insurance for injury.

l)         Sports associations must have in place emergency procedures in the event of injury.

m)      Signature on this application indicates approval of condition of ball field/playing field.

n)       Applicant is responsible for delivery and pick up of outdoor mobile restroom.         

               

 

Applicant Signature_______________________________________________Date___________________________

 

 

 

Text Box: OFFICE USE ONLY	APPLICATION APPROVED    ˙Yes     ˙ No     Date ___________________

Security Deposit $ ________________Date Paid___________________Cash/Check #___________________

Rental Fee $ _____________________Date Paid___________________Cash/Check #___________________

Set-Up Fee $ ____________________Date Paid____________________Cash/Check #___________________

Total Balance Due $ ____________Date Due______________Date Paid___________Cash/Check #_________