HAMPSHIRE NEIGHBORHOOD ASSOCIATION, INC.

6006 HAMPSHIRE CIRCLE

WALDORF, MD 20603

301/645-7233

Permission is hereby requested by ______

(INDIVIDUAL AND/OR ORGANIZATION

to use the ______on ______ at the Hampshire Neighborhood

(ROOM LOCATION)(DATE)

Center or other equivalent space provided by the HNA for the purpose of conducting a ______.

(TYPE OF ACTIVITY)

If granted, this contract is issued with the understanding that:

______

(NAME OF RESPONSIBLE PARTY REQUESTING FACILITY)

of ______

(ADDRESS OF RESPONSIBLE PARTY)

(HOME PHONE) ______(WORK PHONE) ______

is twenty one (21) years of age or older and will be responsible for adherence to regulations for the use of the HNA facilities and to the general rules attached to this permit. It is understood that HNA shall not be liable for injury to persons or property occurring in or about the premises from any cause whatsoever. Licensee will indemnify HNA for and save it harmless from and against any and all claims, actions, damages, liability and expense in connection with injury to persons or property arising from or out of the use or occupancy of Licensee of the premises, or occasioned wholly or in part by any act or omission of Licensee, its agents, employees, invitees or licensees. It is understood that this contract MAY BE CANCELED and VOIDED with NO REFUND of deposit and/or rental fees paid if it is discovered that Licensee has given false information at the time of contract signing.

THIS CONTRACT MUST BE PRESENTED AT THE TIME THE KEY IS ISSUED AND MUST ALSO BE ON THE RENTAL PREMISES AT THE TIME OF THE EVENT.

______

SIGNATURE OF RESPONSIBLE PARTY REQUESTING PERMITDATE

IDENTIFICATION: (A COPY OF THE ID IS TO BE ATTACHED TO CONTRACT)

_____ DRIVER'S LICENSE_____ MILITARY I.D.

_____ VOTER'S REGISTRATION_____ OTHER

EMERGENCY CONTACTS:KAYTIE301/609-2906CHRISTINE 301/706-2082

TYPE OF ACTIVITY ______

DATE OF ACTIVITY ______TIME: FROM ______TO ______

(NOTE: ANY TIME NEEDED FOR SET-UP AND CLEAN-UP MUST BE INCLUDED IN YOUR RENTAL TIME.) ______

NUMBER OF PARTICIPANTS ______

SECURITY DEPOSIT ______RENTAL FEE ______

FEE FOR SECURITY GUARD ______SECURITY GUARD HOURS ______

TOTAL AMOUNT DUE AT TIME CONTRACT IS SIGNED ______

AMOUNT RECEIVED ______CHECK ______CASH ______

RECEIVED BY ______

(for HAMPSHIRE NEIGHBORHOOD ASSOCIATION, INC.)

NEIGHBORHOOD ASSOCIATION EQUIPMENT REQUIRED:

______FOLDING CHAIRS______TABLES______KITCHEN FACILITIES

KEY TO BE PICKED UP ON ______

IT IS UNDERSTOOD THAT NO ADMISSION FEES OR DONATIONS WILL BE COLLECTED FROM GUESTS ATTENDING THIS FUNCTION.

PERMIT GRANTED THIS ______DAY OF ______, ______.

TO ______

(NAME OF INDIVIDUAL AND/OR ORGANIZATION)

*** ______

(SIGNATURE OF RESPONSIBLE PARTY)

FOR THE USE OF THE HAMPSHIRE NEIGHBORHOOD CENTER.

______

(SIGNATURE OF MANAGEMENT EMPLOYEE WITNESSING/ISSUING CONTRACT)

*** KEY PICKED UP BY ______

(SIGNATURE OF INDIVIDUAL PICKING UP KEY)

DATE KEY PICKED UP______KEY TO BE RETURNED NO LATER THAN ______

KEY RETURNED ______

(SIGNATURE OF AGENT RECEIVING KEY)

REFUND CHECK ISSUED - CHECK # ______DATE ______

DEPOSIT HELD BECAUSE ______

______

HAMPSHIRE NEIGHBORHOOD ASSOCIATION, INC.

GENERAL RULES FOR RENTAL

  1. Hampshire Neighborhood Association, Inc. (HNA) facilities may be used by individuals or groups/organizations at the discretion of the HNA and its authorized agents, any time the facilities are not previously scheduled. Contracts need to be completed within forty-eight (48) hours of booking request or the booking request will be voided. All fees are to be paid three (3) weeks prior to the event. RESIDENTS MUST BE IN GOOD STANDING. REQUESTS FOR PERMISSION TO USE THE FACILITIES MUST BE MADE AT LEAST THREE WEEKS IN ADVANCE.
  1. The fees are as follows:
  1. The Licensee will deposit with HNA the sum of $200.00 as security at the time the contract is signed. Cancellations may be initiated by the Licensee up to one (1) week prior to scheduled use; however, a $25 service fee will be charged. If cancellation of a booking is made less than one (1) week prior to the event, the ENTIRE ROOM FEE IS FORFEITED. Future use of the HNA facilities will be denied until cancellation fees are paid. The HNA will issue cancellation notices as far in advance as possible, but reserves the right to later cancellation in the case of extreme necessity.
  2. Rental fee of $25 per hour.
  3. In addition to the hourly rental fee, a security guard will be required for events with a DJ, band, alcohol, teen party and/or after 6 pm. The security guard fee is $30 per hour, with a four (4) hour minimum.
  4. All fees must be prepaid.
  5. If you exceed your rental time, the extra costs will be subtracted from your security deposit.

______

  1. The security deposit will be refunded within thirty (30) days after the rental key is returned, provided the premises, facilities and equipment are left in satisfactory condition. The HNA reserves the right to deduct from the deposit any amount necessary to cover the costs of excessive clean up and the costs of repairs and in the event you exceed your rental time and/or replacement of property. If the security deposit does not fully cover these costs, the user will be billed for the difference, and the future use of the facility will be denied until these costs are paid. Groups/individuals using the facility are responsible for any and all damages that occur due to or during their use of the facility.

4.Under no circumstances will chairs, tables, or other equipment be removed from the premises.

  1. If decorations are contemplated, the management office must be notified of the nature of the decorations and HNA reserves the right to have an inspection made by a representative of the Fire Department of Charles County. All decorations used must be flame proof, and NO USE OF TACKS, NAILS, SCREWS, TAPE OR OTHER FASTENERS will be permitted for hanging decorations. Under no circumstances will any renter make any structural or electrical alterations in the building.
  1. The HNA assumes no responsibility for the personal property of the Licensee, and the Licensee will remove all such property from the premises at the end of the reserved time period.
  1. THE ISSUED PERMIT MUST BE IN THE POSSESSION OF THE PERSON TO WHOM IT IS ISSUED AND, UPON REQUEST, BE SHOWN TO ANY AUTHORIZED AGENT OF THE HNA. THE PERSON TO WHOM THE PERMIT IS ISSUED MUST BE IN ATTENDANCE AT ALL TIMES DURING THE EVENT. FAILURE TO BE IN ATTENDANCE WILL RESULT IN LOSS OF SECURITY DEPOSIT AND/OR SHUT DOWN OF THE EVENT.
  1. The maximum number allowed at any event is 80 people. At gatherings of people aged 13 to those under the age of twenty one (21), adequate supervision must be provided. Chaperons are required for these groups at the ratio of one adult for every eight (8) children. Names, addresses and telephone numbers of chaperons will be furnished to the management office at the time the contract is signed. There is a maximum of 50 people allowed for these functions.

9.HNA RESERVES THE RIGHT TO REFUSE OR CANCEL PERMITS.

10.If any of the specifics regarding this contract are altered in any way from the original statement of intent by the Licensee, as shown on the contract, it is the responsibility of the Licensee to submit such changes, in writing, to the management office at least ten (10) days in advance of the scheduled event. All alterations must have approval of the management office. IN THE EVENT THE LICENSEE GIVES NO NOTICE, OR NO CLEARANCE IS RECEIVED FROM THE HNA WHEN SUCH MODIFICATIONS HAVE BEEN MADE, THE LICENSEE WILL BE HELD LIABLE. The HNA will make the final determination if additional charges to the Licensee are necessary if any adverse situations arise as a consequence of inadequate notification and/or HNA approval. FURTHER BOOKING REQUESTS OF HNA WILL NOT BE HONORED.

11.THERE MAY BE ONLY ONE SOURCE OF MUSIC DURING ANY GIVEN FUNCTION.

  1. THERE WILL BE A $25.00 CHARGE IN THE EVENT YOU LOCK YOURSELF OUT OF THE BUILDING.
  1. THERE WILL BE A $200.00 CHARGE IN THE EVENT YOU SET OFF THE ALARM SYSTEM. THIS AMOUNT WILL BE DEDUCTED FROM YOUR SECURITY DEPOSIT.
  1. PERMITS ARE NOT TRANSFERABLE.
  1. THE FACILITIES ARE TO BE LEFT IN APPROPRIATE AND SUITABLE CONDITIONS AS DEEMED BY HNA. FLOORS ARE TO BE SWEPT, SPILLS MOPPED, TABLES WIPED, EQUIPMENT RETURNED TO PROPER PLACE AND ALL TRASH TO BE HAULED TO THE DUMPSTER AREA ACROSS FROM THE SWING SET ON THE LEFT SIDE OF THE BUILDING.
  1. ALL FUNCTIONS MUST BE ENDED BY 12 a.m. (MIDNIGHT) AND THE CENTER MUST BE CLEANED AND EVERYONE OUT BY 1 a.m.
  1. IT IS UNDERSTOOD THAT THE HNA AND/OR ITS AUTHORIZED REPRESENTATIVE HAS THE AUTHORITY TO SHUT DOWN THE EVENT BEING HELD WITH NO REFUND OF FEES DUE TO ANY MISUSE OF THE FACILITIES OR ANY FRAUDULENT OR ILLEGAL ACT.

18.THE USE OF THE FACILITY IS FOR PRIVATE FUNCTIONS ONLY. PUBLIC ADVERTISEMENT (INCLUDING THE DISTRIBUTION OF FLYERS AND/OR THE USE OF FLYERS OR PUBLIC NOTIFICATIONS OR ANY NOTIFICATION NOT SPECIFICALLY ADDRESSED TO AN INDIVIDUAL) IS STRICTLY PROHIBITED AND WILL RESULT IN THE FUNCTION BEING SHUT DOWN WITH NO REFUND OF THE SECURITY DEPOSIT.

LICENSEE HAS READ AND AGREES TO COMPLY WITH ALL OF THE ABOVE RULES, REGULATIONS AND CONDITIONS.

______

(SIGNATURE OF RESPONSIBLE PARTY) (DATE)