High Prairie Community Center – Rental Application Contact the Facility Coordinator to schedule your event – highprairiereservations@gmail.com HPCC Rental Application Name of Org./Party Contact Person Contact Person First Name First Name Last Name Last Name Address Phone Number Email Desired date of event: Start time of event: Duration of event: Up to 4 hours4-8 hoursOver 8 hours Description of activity: Business MeetingCommissary KitchenDonation-Based ActivityExempt from Rental Fees Kitchen use? Yes No Estimated Attendance: Audio/Visual Equipment: Yes No I certify that I am the authorized representative of the above organization/group and that all of the information I have supplied above is true. I have read and agree to be bound by the regulations, policies and fee schedules described in the accompanying High Prairie Community Center Rental Information document. I agree to ensure supervision of all activity on the premises and to comply with and enforce the Facility Use Policies during the time allocated for our group. I agree that after our event we will return the Community Center (main hall, hallway, bathrooms and kitchen) and the surrounding grounds to clean condition. HOLD HARMLESS AGREEMENT: On behalf of the group I represent, I agree to hold the High Prairie Community Center, the High Prairie Community Council, its agents, employees and officials, while acting within the scope of their duties, harmless from all causes of actions, demands, and claims, including the cost of their defense, arising in favor of the activity participant or third parties on account of personal injuries, death or damage to property arising out of activities at the premises and in any way connected with the activities of the activity participant in the above event except for those acts or commissions which are the sole negligence of the High Prairie Community Center, the High Prairie Community Council, its agents, employees and officials. CHECKING THIS BOX indicates that you have read, understand and agree to the Rental Policies and Procedures and Facility Use Policies of the High Prairie Community Center. * Agree Name & Title (if any) Name & Title (if any) First Name First Name Last Name Last Name Date HPCC Representative & Title HPCC Representative & Title First Name First Name Last Name Last Name Date Total Rental Fee ($) Total Deposit ($) Balance Due ($) Make checks payable to “High Prairie Community Council.” Submit If you are human, leave this field blank. Δ
