ࡱ> jli @ HQbjbj00 \RbRb$8d>4m3x~v()$$$$E%+j2$4R7722'3!!!4$!$!!!$r fN$$=30m3$77$7$$hYJ!<;22!Jones House Community and Cultural Center Public Event or Reception Form (This form is intended for events to be attended by more than 25 persons a separate Grounds Usage Form is required if the event also includes activities on the lawn or in the parking lot. Parking for your event attendees is available in the parking lot and does not require a separate form.) Person making arrangements (Responsible Party)  FORMTEXT       Title  FORMTEXT       Address  FORMTEXT       City  FORMTEXT       State  FORMTEXT       Zip  FORMTEXT       Telephone  FORMTEXT       (day)  FORMTEXT      (night) Email  FORMTEXT       Alternate number  FORMTEXT        Contact Person  FORMTEXT       Title  FORMTEXT       Address  FORMTEXT       City  FORMTEXT       State  FORMTEXT       Zip  FORMTEXT       Telephone  FORMTEXT       (day)  FORMTEXT       night) Email  FORMTEXT       Alternate number  FORMTEXT       Will this person be present at all times during the event?  FORMTEXT       If not, who will be present and in charge when the contact person is not present?  FORMTEXT       Type of Event  FORMTEXT       Date of event  FORMTEXT       Time of event  FORMTEXT       Set-up time/day  FORMTEXT       Clean-up time/day  FORMTEXT       (No supplies or food may be brought into the building prior to the scheduled time of usage, nor left afterwards. Please allow adequate time for set up and clean-up when reserving the building. Setting up or cleaning up on any other date than the date of the event requires additional rental fees and may not be allowed if the buildings schedule is too busy at that time of year. It is far more preferable to plan to set up and clean up on the same day if at all possible.) Room(s) to be Used or Decorated  FORMTEXT       Estimated Number Attending  FORMTEXT        Caterer s Name  FORMTEXT       Telephone Number  FORMTEXT       Will you be serving alcohol?  FORMTEXT       Type  FORMTEXT       Bartender s Name  FORMTEXT       Date and number of alcohol permit  FORMTEXT       Other Professional (Performer, DJ, etc.)  FORMTEXT       Type of Service  FORMTEXT       Telephone Number  FORMTEXT        If there will be music, sound amplification, or any other noise impact, please describe:  FORMTEXT       The sound equipment of the Jones House Community Center may only be set up and operated by pre-approved persons who are appointed by the Executive Director. If these services are requested, the hourly fee must be paid directly to the appointed sound technician at the end of the event. The Jones House equipment is capable of playing a single CD or an audio-tape. We do not recommend that sound be used inside the building. Will you need sound equipment?  FORMTEXT       What time will this need to be set up? FORMTEXT       How long will you need the sound equipment?  FORMTEXT       How many microphones will be needed?  FORMTEXT       Do you plan to use a CD or an audio-tape?  FORMTEXT       Contact Person for Sound Needs  FORMTEXT       Phone (day)  FORMTEXT       (night)  FORMTEXT        Please attach or use the reverse side of this page to provide a complete schedule of all plans and activities (from setup through cleanup) with times and e*Jr    0 2 4 > @ P R T h j l v x z غ̨̟؍̨~sa~L~(jhIheOJQJUmHnHu#jhIhs0OJQJUhIheOJQJjhIheOJQJU#jthehs0OJQJUhs0>*OJQJ"jheOJQJUmHnHu#jhehs0OJQJUjheOJQJUheOJQJhs0OJQJhs05OJQJhs05CJOJQJhs0*IJq r  B z    ^ Z (qrnrdhdhgdegds0gde$a$PFQ      $ ( * > @ B L N P X \ ^ r t v n#j,hehs0OJQJU#jhehs0OJQJUhs0>*OJQJ#jDhehs0OJQJU#jhehs0OJQJUhs0OJQJ"jheOJQJUmHnHu#j\hehs0OJQJUheOJQJjheOJQJU+      2 4 H J L V X f h | ~ 󿡿}k#jhOCheOJQJU#jhOCheOJQJU#j2hOCheOJQJUjhs0OJQJU#jhehs0OJQJUhs0OJQJ"jheOJQJUmHnHu#jhehs0OJQJUheOJQJjheOJQJU&     * , 6 8 L N P Z \ ^ r t v#jlhOCheOJQJU#jhOCheOJQJU#jhOCheOJQJU#j hOCheOJQJU"jheOJQJUmHnHu#jhOCheOJQJUjheOJQJUheOJQJhe>*OJQJ(  24HJLVX&(<>ǵǣǑDžsa#j hOCheOJQJU#jb hOCheOJQJUj heOJQJU#jD hOCheOJQJU#j hOCheOJQJU#jX hOCheOJQJUheOJQJ"jheOJQJUmHnHujheOJQJU#jhOCheOJQJU&>@JLjl"$&(qr  FH\٬ٚپv#j hOCheOJQJUheCJOJQJhs0OJQJ#j: hOCheOJQJU#j hOCheOJQJUhe>*OJQJ#jN hOCheOJQJUheOJQJ"jheOJQJUmHnHujheOJQJU'\^`jlnp<>RTV`bnpĸneS#j0hs0hs0OJQJUhs0>*OJQJ#jhs0hs0OJQJU"jhs0OJQJUmHnHu#jDhs0hs0OJQJUjhs0OJQJUhs0OJQJjhs0OJQJUhs0hs0OJQJ"jheOJQJUmHnHujheOJQJU#j&hOCheOJQJULNZ^:<rhL<f=dhd^ $d^a$ d^gds0$&:<>HJ 24HJLVƾᾬᾚᾈvd#jhs0hs0OJQJU#j~hs0hs0OJQJU#jhs0hs0OJQJU#jhs0hs0OJQJU#jhs0hs0OJQJUhs0OJQJhs0>*OJQJ"jhs0OJQJUmHnHujhs0OJQJU#jhs0hs0OJQJU'VXZ\^(*,68:JL`bdnpǽǕǽǽ{ǕǽǽgǕǽǽS'jths0hs0CJOJQJU'jhs0hs0CJOJQJU'jhs0hs0CJOJQJU hs0CJ&jhs0CJOJQJUmHnHu'jhs0hs0CJOJQJUhs0CJOJQJjhs0CJOJQJUhs0OJQJ^Jjjhs0OJQJUhs0OJQJjhs0OJQJU >@TVXbd$&:<>HJdfz|~ԬԘԄphhs0OJQJ'jhs0hs0CJOJQJU'jLhs0hs0CJOJQJU'jhs0hs0CJOJQJU'j`hs0hs0CJOJQJU'jhs0hs0CJOJQJUhs0CJOJQJjhs0CJOJQJU&jhs0CJOJQJUmHnHu& <<f=2>4>H>J>L>V>X>Z>\>^>r>t>v>>>(?*?@@CCFFFGGHHIΧΧuqfYhs05CJOJQJ\hs05OJQJ\hs0hs05CJOJQJhs05>*OJQJ&jVhs0hs05OJQJUhs0OJQJ%jhs05OJQJUmHnHu&jhs0hs05OJQJUjhs05OJQJUhs056OJQJ]Uhs05OJQJj8hs0OJQJU"vent details, indicating which portions of the building will be used during each part of the event. Permission to use the facility will not be granted without this schedule. List below all furniture you would like to move (permission must be granted by Executive Director):  FORMTEXT        FORMTEXT       Rental of the entire building is required for private events. A cleaning deposit is required for all private meetings and receptions and may be refunded at the discretion of the Executive Director. Plans to serve alcohol must be approved in advance by the Executive Director and an additional alcohol deposit is required and may be refunded at the discretion of the Executive Director. A staffing fee is required for all private events and is payable directly to the staff person at the completion of the event. If sound equipment is to be used, an hourly fee to be paid to the appointed sound technician is required for all private events and is payable at the completion of the event. Any fees owed for exceeding the scheduled hours will be deducted from the applicable deposits. Failure to comply with the rental policies of the Jones House Community Center will result in the forfeiture of all deposits. All monies are deposited with the Town of Boone and refund checks are issued through the town. A processing fee will be charged by the town for returned checks. THE ARRANGEMENTS LISTED ABOVE ARE INVALID WITHOUT THE FOLLOWING SIGNATURES: I have received a copy of the Jones House Community Center Usage and Rental Policies and have read them and agree to all conditions and requirements outlined therein. Signed Date (Responsible Party)  I have met with the appropriate parties listed above and approve all activities described herein. Signed Date (Executive Director) Payment Record: Deposits: Date pd________________ Amount pd_____________ Accepted by____________ Rental Fee: Date pd________________ Amount pd_____________ Accepted by____________ Assigned Staff person_____________________________________ Phone ___________________ Assigned Sound Technician _______________________________ Phone ___________________ CONDITION of Premises following Usage _________________________________________________________________________________________ _________________________________________________________________________________________ Staff Signature ____________________________________________ Date Inspected __________________________ Deposit Refunded (amount)__________________________________ Date Refund Authorized to Town of Boone ____________________________ Notes: Page  PAGE 1 of  NUMPAGES 3 f=h=j=Z>\>>?@ABCCFFFFFGGHHIBIFIJJ>JlJ$a$ & FIIIIBIDIJ(J0J>JlJnJ8M:NNOlOOO>PPPPQ QQQQQ$Q&Q:QQ@QDQFQHQ{hIhI0JmHnHu hs00Jjhs00JUhs0hs0CJOJQJ\ hs05hs0CJOJQJ^J hs05CJhs0CJOJQJhs0CJOJQJ\jhs0OJQJUhs0>*OJQJhs05>*OJQJhs05OJQJ%lJnJJJ6KNKKKLL8M:M:N#$d%d&d'dNOPQ&$$d%d&d'dNOPQa$#$d%d&d'dNOPQ :NNNOO>P@PPPPPPPPPPP#$d%d&d'dNOPQ#$d%d&d'dNOPQ&$$d%d&d'dNOPQa$PPPPPPPPPPPPBQDQFQHQ$a$$a$#$d%d&d'dNOPQ/ =!"#$%tDText1tDText2tDText3tDText4tDText5tDText6tDText7tDText8tDText9vDText10Dd#j\  3 wS"5#((vDText11vDText12vDText13vDText14vDText15vDText16vDText17vDText18vDText19vDText20vDText21vDText22Dd#j\  3 wS"5#((vDText23vDText24vDText25vDText26vDText27vDText28vDText29Dd#r\  3 wS"9#((vDText30vDText31vDText32vDText33vDText34vDText35vDText36vDText37vDText38Dd#r\  3 wS"9#((vDText39vDText40vDText41vDText42vDText43vDText44vDText45vDText47vDText46Dd#r\  3 wS"9#((vDText48vDText49Dd#r\  3 wS"9#((L@L Normal5$7$8$9DH$CJ_HmH sH tH H@H Heading 1$@&5CJOJQJ^JDA@D Default Paragraph FontViV  Table Normal :V 44 la (k(No List :B@: Body Text CJOJQJBP@B Body Text 25CJOJQJZR@Z Body Text Indent 2dh^ CJOJQJHQ@"H Body Text 3dh5OJQJ^J<>@2< Title$a$5CJOJQJ4B4 Header  !4 @R4 Footer  !.)@a. 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