Community Room Rental Application This application is a request to reserve the Community Room for the time and date requested. All requests should be submitted a minimum of fourteen (14) days in advance. The community Room may not be used for fundraising or promotional uses. This is not an agreement and creates no right to use the Community Room. The City of Clever reserves the right to refuse any Community Room reservation request. Applicant Name* First Last Applicant Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Applicant Phone*Applicant Email* Enter Email Confirm Email Name of Business or Organization (if applicable)Business NameBusiness Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Business PhoneBusiness Email Enter Email Confirm Email Requested Date and Time of EventDate* Time* : HH MM AM PM Total Number of People in Attendance*Maximum seating capacity of the Community Room is 50Please enter a value between 1 and 50.Is Food or Beverages Being Served?*NoYesPurpose of Reservation*Please be as specific as possible and describe the nature of the reservation, including planned activities. Community Room License Regulations and Requirements1. Licensee must be twenty-one (21) years of age or older. 2. The Community Room is a Non-smoking facility which includes Electronic Cigarettes (e-cigs). Licensee shall ensure that no smoking occurs within the facility and will be held responsible for a cleaning fee should the City determine that cleaning be required. 3. Exits shall not be obstructed in any manner and shall remain free of any material or matter where its presence would obstruct or render the exits hazardous. 4. The maximum number of people allowed in or around the Community Room shall be fifty (50) 5. The Community Room is available between the hours of 9 a.m. and 11:30 p.m. -a. Set up and clean up must occur within the available hours. -b. The City shall have the right to waive and/or adjust use fees as appropriate for community groups, 501 (c) organizations, and for City co-sponsored activities. -c. Damage/Security deposit. A deposit of $25.00 is required and will be held by the City. If any damage occurs, the deposit will be used toward payment of such damages and the Licensee will be responsible and liable for all damages in excess of the amount of deposit. If there is no damage or other violations of this agreement, a full refund will be issued. -d. Keys - The Licensee shall be responsible for locking up the facility and returning the key to the City the next business day. If the key is lost, the Licensee will be charged a lost key fee of $50.00. If the Community Room is not properly locked and secured, the security deposit will not be refunded. -e. All room cancellations will be refunded in full. 6. The following items are not permitted. a. Do NOT place chairs, tables, or any other items against the walls. If walls are damaged, it will be deducted from the deposit. b. Adhesive tapes or thumbtacks on the walls, tables, or chairs. However, masking and scotch tape can be used on tables provided it is completely removed during clean up. c. Confetti or glitter inside or outside the Community Room. d. Open flames of any kind, bands, disk jockeys, or loud music without the expressed written consent of the City. e.Alcoholic beverages of any kind in the Community Room or on City property f. Animals, except for assist animals, in the building 7. Licensee shall be responsible for clean up, including but not limited to: removal of all decorations, sweeping, moping, emptying of trash receptacles, cleaning of restrooms, counters, tables, chairs, kitchen, etc. If trash is not removed from the building, a fee will be deducted from the security deposit. 8. There shall be: a. One (1) adult for every eight (8) children under the age of thirteen (13) years. b. One (1) adult for every twelve (12) children between the ages of thirteen (13) to sixteen (16) years. 9. All activities shall be contained and take place within the facility and shall not be carried out on the parking lot and/or sidewalks surrounding the building. 10. the city or its agents reserves the right to direct the Licensee and any guest(s) to cease any and all activities at its sole discretion, also reserves the right to direct the Licensee and all guest(s) to vacate the facility for a violation of the terms defined herein or for public safety. the Licensee's use fee will not be refunded and Licensee shall be responsible for all clean up and damages as defined herein. 11. Licensee shall assume full and exclusive responsibility for the cost of repair or replacement of any property, fixtures, and/r equipment damaged during the periods covered by the Community Room License Agreement. 12. The City of Clever is not responsible for stolen items or loss of personal property. The City of Clever does not deny access the the Community Room to anyone on the basis of race, religion, sex, creed, national origin, or political views. Further, permitting any group to use the Community Room does not imply the endorsement of any such views, by the City of Clever. The facility may be denied to a specific organization or individual based upon knowledge of the City of such groups or individuals being unreliable, causing damage to or peace disturbance in other public facilities in Clever or other neighboring communities, or when disruption, damage, theft, or other unfavorable history is recorded from previous use of the Community Room or meetings, gatherings, or events in other communities.By checking this box I understand and agree to abide by the aforementioned regulations and requirements* I Agree to the regulations and requirements Electronic SignatureThe information contained herein is true, and correct and complete to the best of my knowledge and belief. If not being signed by the Applicant, I am authorized by the Applicant on their behalf and have read this application in its entirety. Electronic Signature*By checking the box below, you agree that the information contained within this application is completed to the best of your ability and that willfully falsifying statements on this application constitutes a crime in the State of Missouri. I agree to submit my application electronically to the City of Clever Please Type Your Name* First Last CAPTCHA
