Common use of Facility Requested Clause in Contracts

Facility Requested. Com. Center Gym (without use of kitchen) Com. Center Gym (with use of kitchen) Com. Center Room #2 Com. Center Room #3 Com. Center Room #6 Chamber of Commerce Shelter Large Pavilion (without use of kitchen) Large Pavilion (with use of kitchen) Small Pavilion (no kitchen) Soccer Field (north of cemetery) Ball Field (north) Ball Field (south) Xxxxxxxxxx Park Fitness Room Key Fob Start date Start time End date End time Purpose Facility Usage Requested By Name Address City, State, Zip Email Organization Driver license # Phone User Agreement The assigned security Code/Fob is your responsibility. DO NOT share this Code/Fob with anyone. You must use your Code/Fob to enter the building and you may also be required to use it to lock the building upon your departure. You may be held responsible for any unauthorized use or damage that may occur during the times the electronic system indicates the building was accessed by your Code/Fob, including your Code/Fob being deactivated. A person of at least 16 years of age must be present at all times and assumes responsibility for any damage during the time your Code/Fob is recorded in use. You may request that your Code/Fob be deactivated if you suspect that it has been comprised in any way. You may also deacti- vate your Code/Fob if suspicious activity or misuse of the facility is suspected at any time. The facility must be left as found, including returning all tables and chairs to where they were upon your arrival. Key Fob must be returned within 48 hours after your event. I acknowledge receipt of St. Germain Code of Ordinance, Chapter 17 – Community Parks & Buildings Usage I assume responsibility for the facility during the time the Electronic Security Code/Fob is assigned to me. Save completed form to your device, then send it as an email attachment to: xxxx.xxxxx@xxxxxxxxxxx.xxx Signature Date

Facility Requested. Com. Center Gym (without use of kitchen) Com. Center Gym (with use of kitchen) Com. Center Room #2 Com. Center Room #3 Com. Center Room #6 Chamber of Commerce Shelter Large Pavilion (without use of kitchen) Large Pavilion (with use of kitchen) Small Pavilion (no kitchen) Soccer Field (north of cemetery) Ball Field (north) Ball Field (south) Xxxxxxxxxx Park Fitness Room Key Fob (single use) Start date Start time : am / pm End date End time : am / pm Purpose Facility Usage Requested By Name Address City, State, Zip Email Phone Organization Driver license # Phone User Agreement The assigned security Code/Fob is your responsibility. DO NOT share this Code/Fob with anyone. You must use your Code/Fob to enter the building and you may also be required to use it to lock the building upon your departure. You may be held responsible for any unauthorized use or damage that may occur during the times the electronic system indicates the building was accessed by your Code/Fob, including your Code/Fob being deactivated. A person of at least 16 18 years of age must be present at all times and assumes responsibility for any damage during the time your Code/Fob is recorded in use. You may request that your Code/Fob be deactivated if you suspect that it has been comprised in any way. You may also deacti- vate your Code/Fob if suspicious activity or misuse of the facility is suspected at any time. The facility must be left as found, including returning all tables and chairs to where they were upon your arrival. Key K ey Fob must be returned within 48 hours after your event. I acknowledge receipt of St. Germain Code of Ordinance, Chapter 17 – Community Parks & Buildings Usage I assume responsibility for the facility during the time the Electronic Security Code/Fob is assigned to me. Save completed form to your you device, then send it as an email attachment to: xxxx.xxxxx@xxxxxxxxxxx.xxx Signature Datexxxxxxxx@xxxxxxxx.xxx Electronic signature Date Rental Agent Use Usage fee Date received Facility deposit Date received Security deposit Date received Issued: Key Security code #

Facility Requested. Com. Center Gym (without use of kitchen) Com. Center Gym (with use of kitchen) Com. Center Room #2 Com. Center Room #3 Com. Center Room #6 Chamber of Commerce Shelter Large Pavilion (without use of kitchen) Large Pavilion (with use of kitchen) Small Pavilion (no kitchen) Soccer Field (north of cemetery) Ball Field (north) Ball Field (south) Xxxxxxxxxx Park Fitness Room Key Fob (single use) Start date Start time : am / pm End date End time : am / pm Purpose Facility Usage Requested By Name Address City, State, Zip Email Organization Driver license # Phone User Agreement The assigned security Code/Fob is your responsibility. DO NOT share this Code/Fob with anyone. You must use your Code/Fob to enter the building and you may also be required to use it to lock the building upon your departure. You may be held responsible for any unauthorized use or damage that may occur during the times the electronic system indicates the building was accessed by your Code/Fob, including your Code/Fob being deactivated. A person of at least 16 years of age must be present at all times and assumes responsibility for any damage during the time your Code/Fob is recorded in use. You may request that your Code/Fob be deactivated if you suspect that it has been comprised in any way. You may also deacti- vate your Code/Fob if suspicious activity or misuse of the facility is suspected at any time. The facility must be left as found, including returning all tables and chairs to where they were upon your arrival. Key Fob must be returned within 48 hours after your event. I acknowledge receipt of St. Germain Code of Ordinance, Chapter 17 – Community Parks & Buildings Usage I assume responsibility for the facility during the time the Electronic Security Code/Fob is assigned to me. Save completed form to your you device, then send it as an email attachment to: xxxx.xxxxx@xxxxxxxxxxx.xxx Signature DateElectronic signature Date Rental Agent Use Usage fee Date received Facility deposit Date received Security deposit Date received Issued: Key Security code #

Facility Requested. Com. Center Gym (without use of kitchen) Com. Center Gym (with use of kitchen) Com. Center Room #2 Com. Center Room #3 Com. Center Room #6 Chamber of Commerce Shelter Large Pavilion (without use of kitchen) Large Pavilion (with use of kitchen) Small Pavilion (no kitchen) Soccer Field (north of cemetery) Ball Field (north) Ball Field (south) Xxxxxxxxxx Park Fitness Room Key Fob (single use) Start date Start time : am / pm End date End time : am / pm Purpose Facility Usage Requested By Name Address City, State, Zip Email Phone Organization Driver license # Phone User Agreement The assigned security Code/Fob is your responsibility. DO NOT share this Code/Fob with anyone. You must use your Code/Fob to enter the building and you may also be required to use it to lock the building upon your departure. You may be held responsible for any unauthorized use or damage that may occur during the times the electronic system indicates the building was accessed by your Code/Fob, including your Code/Fob being deactivated. A person of at least 16 18 years of age must be present at all times and assumes responsibility for any damage during the time your Code/Fob is recorded in use. You may request that your Code/Fob be deactivated if you suspect that it has been comprised in any way. You may also deacti- vate your Code/Fob if suspicious activity or misuse of the facility is suspected at any time. The facility must be left as found, including returning all tables and chairs to where they were upon your arrival. Key K ey Fob must be returned within 48 hours after your event. I acknowledge receipt of St. Germain Code of Ordinance, Chapter 17 – Community Parks & Buildings Usage I assume responsibility for the facility during the time the Electronic Security Code/Fob is assigned to me. Save completed form to your you device, then send it as an email attachment to: xxxx.xxxxx@xxxxxxxxxxx.xxx Signature Datexxxx.xxxxx@xxx.xxxx Electronic signature Date Rental Agent Use Usage fee Date received Facility deposit Date received Security deposit Date received Issued: Key Security code #

Facility Requested. Com. Center Gym (without use of kitchen) Com. Center Gym (with use of kitchen) Com. Center Room #2 Com. Center Room #3 Com. Center Room #6 Chamber of Commerce Shelter Large Pavilion (without use of kitchen) Large Pavilion (with use of kitchen) Small Pavilion (no kitchen) Soccer Field (north of cemetery) Ball Field (north) Ball Field (south) Xxxxxxxxxx Park Fitness Room Key Fob Start date Start time : am / pm End date End time : am / pm Purpose Facility Usage Requested By Name Address City, State, Zip Email Organization Driver license # Phone User Agreement The assigned security Code/Fob is your responsibility. DO NOT share this Code/Fob with anyone. You must use your Code/Fob to enter the building and you may also be required to use it to lock the building upon your departure. You may be held responsible for any unauthorized use or damage that may occur during the times the electronic system indicates the building was accessed by your Code/Fob, including your Code/Fob being deactivated. A person of at least 16 years of age must be present at all times and assumes responsibility for any damage during the time your Code/Fob is recorded in use. You may request that your Code/Fob be deactivated if you suspect that it has been comprised in any way. You may also deacti- vate your Code/Fob if suspicious activity or misuse of the facility is suspected at any time. The facility must be left as found, including returning all tables and chairs to where they were upon your arrival. Key Fob must be returned within 48 hours after your event. I acknowledge receipt of St. Germain Code of Ordinance, Chapter 17 – Community Parks & Buildings Usage I assume responsibility for the facility during the time the Electronic Security Code/Fob is assigned to me. Save completed form to your device, then send it as an email attachment to: xxxx.xxxxx@xxxxxxxxxxx.xxx Signature Electronic signature Date