REQUESTED USE. Describe the intended use of the Academic Data Set, including the intended Derivative Works. A study proposal may be attached.
REQUESTED USE. (Fees include use of furnishings, appliances and kitchen items, but not paper/plastic plates, cups utensils.) o Main room with no food $15.00 o Main room with food and/or drink $30.00 A security deposit of $150.00 is required for all rentals. o Entire main floor with no food $30.00 The deposit will be returned/shredded after inspection. o Entire main floor with food and/or drink $50.00 The two checks must be made payable to DVCA. The DVCA Policy governing Clubhouse Rental and the Clubhouse Clean-up Checklist are attached. By signing this document and the policy the resident agrees to abide by all rules. The resident requesting private use of the clubhouse must agree to and accept the following indemnity and hold harmless clause: In connection with the reservation and use of the clubhouse and its facilities, the undersigned agrees to indemnify and hold harmless the Deerlake Village Community Association, Inc., any committees or persons appointed by the Board of Directors to manage the clubhouse and its facilities and any or all of the oth- er members of the Deerlake Village Community Association, Inc., from any liability, loss or damage arising out of said use or caused by the undersigned or any of his/her guests or invitees. Loss or damage shall include rea- sonable attorneys’ fees incurred in connection with the enforcement or application of this provision. I understand that this rental does not include use of the pool and pool area, lake, or picnic grove. Initial by resident: I understand that if the TV and/or related equipment will be used I will be the sole operator of said equip- ment and that neither the piano nor the buffet will be moved. Initial by resident: I understand that I must be present at all times including set up, clean up and for the duration of the event, that a member of theClubhouse Committee may visit at any time, and that failure to abide by these rules may result in loss of the right to rent the clubhouse for the period of one year . Initial by resident: Resident’s signature: Date: For Clubhouse Committee Use Only Date reservation received: Security check # Rental fee check # (copy of checks attached) Date of inspection: o Condition OK o Condition requires extra clean up. Explanation: o Security deposit returned on . o Partial Security deposit returned on . (Amount ) o Security deposit forfeited.
REQUESTED USE. Purpose The applicant understands and agrees that a person or organization using a City facility is responsible for abiding by all rules and regulations set forth in the City Code or Facilities Use Policies, as may be amended from time to time. The applicant acknowledges and understands that it is the responsibility of applicant to verify the rules and regulations in effect at the time of use. Applicant hereby agrees to release and indemnify and hold the City of Southport and its’ employees, staff and officials harmless from and against any and all claims, suits, losses or related causes of action for damages or injuries arising from the use of the Southport Community Building. I (we) the undersigned agree to abide by the agreement and all rules and regulations for the use of the facility and understand that any damages or clean- up costs may be charged to me. Signature Printed Name Date City Use Fees for use of facility _$ Deposit _$ Date Paid Balance due _$ Date Paid The undersigned authorized agent for the City of Southport agrees to permit use of the Southport Community Building on the following additional if any. Signature Date Xxxxxx Xxxxxx xxxxxx_xxxxxx@xxxxxxxxxxx.xxx 910-457-0665
