THE LITCHFIELD COMMUNITY CENTER, INC.
421 BANTAM ROAD ~ LITCHFIELD, CT 06759
PHONE (860) 567-8302 ~ FAX (860) 567-0328 WWW.THECOMMUNITYCENTER.ORG
A PRIVATE NON-PROFIT ORGANIZATION
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Facility Rental/Use Request
for children's party/special events
Granting of permission to use the community center facilities does not in any way constitute
an endorsement of an individual's or group's particular beliefs or purposes by
The Litchfield Community Center, inc. board of directors, staff or any
affiliate of the organization
For consideration of requests for use of the Center, this form must be completed in its entirety and returned to the Director as soon as possible. An invoice for payment will be presented to the host with an approved use form.
Request must be submitted a minimum of 4 weeks prior to requested date.
All payments shall be received at least 10 business days before the event unless otherwise noted in invoice.
All checks are payable to “The Litchfield Community Center, Inc.”.
Today's Date: __________________ Reservation No.: ___________________
Renter Information: (Please Print Clearly)
Individual/Contact Person: _______________________________________ Email Address _______________________________
Street: ________________________________________________ Home Phone: _________________________________________
Town: ______________________ State: _______ Zip: ________ Business Phone: ________________ Fax: ________________
Event Information:
Day & Date requested:___________________________________ Second Choice: _________________________________
Time of Rental (**Including Set up/Clean up**): From: _____________ To: _____________ Total Hours: ______________
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PLEASE SELECT THE PARTY PACKAGE TO FIT YOUR NEEDS
Party Package I Party Package II Party Package III
Up to 8 guests Up to 12 guests Up to 20 guests
$150.00 $200.00 $250.00
Includes a decorated Includes a decorated Includes a decorated
8” round marble cake ¼ sheet marble cake ½ sheet marble cake
and 1 large Cheese and 2 large Cheese and 3 large Cheese
Pizza serving up to Pizzas serving up to Pizzas serving up to
8 guests. 12 guests. 20 guests.
Check here: ________ Check here: ________ Check here: ________
Birthday Party Guidelines
*Max of 20 children*
*Max of 2 hours*
*3 adult chaperones required*
*Request must be submitted a maximum of 4 weeks prior to required date*
*Please note these are non-alcoholic events. Serving or consumption of alcohol by any member of the party,
including chaperones, will result in early termination of rental and loss of any payment.*
General Terms and Conditions: PLEASE READ BEFORE SIGNING BELOW
Smoking is prohibited in all areas of the facility.
Children accompanying adults must be supervised at all times.
Lessee is responsible for complete clean up and disposal of trash. All trash to be removed to outdoor receptacles. All bottles and cans are to be removed from property by lessee. A disposal fee of $25.00 may be applied if necessary.
All food and drink shall be confined to the main dining area and dining patio.
Certificates of General Liability Insurance may be required for functions held at Community Center. Host group or individual will be notified upon submission of a completed facility use request form.
The Litchfield Community Center reserves the right to decline rental of the facility, rescind a rental contract, or require a cash deposit as prerequisite to rental.
The Lessee agrees to assume and be responsible for any expense(s) incurred for damage(s) to the premises or Center's property resulting from Lessee's use.
The Litchfield Community Center does not accept responsibility for loss or theft of articles belonging to Lessee or any member of his party, or injury or accident to any said person on the grounds of or in the facility, and is absolved by Lessee of all liability, which may result thereof.
The telephone is to be used for emergency or local calls only. Any long distance expenses incurred during a function will be charged to the Lessee.
Taping, mounting or displaying items on any painted surface is not allowed.
Any items/supplies brought into the facility or placed on the Center's property must be removed within 24 hours of the conclusion of the Lessee's event. Items remaining after 24 hours may be disposed of as abandoned property.
A Community Center Staff Member will be on site and available to assist you, or your designated representative, throughout your rental time unless other arrangements have been made with the Executive Director prior to your scheduled event.
____________________________________________________________________________________________________
In requesting the use of The Litchfield Community Center, I hereby acknowledge that I have read and understand the above terms and conditions, that the information provided by myself is true and accurate, and that I accept full and complete responsibility for the conduct and safety of the group and any and all damages that may result as a
consequence of the rental.
Signed: __________________________________________________________________ Date: ___________________________
Agent of The LitchfieldCommunity Center Approval: __________________ Date: _____________
To print a copy of this Facility Use form in .pdf format, click link below...
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