Facility / Equipment Reservation Form

FACILITY / EQUIPMENT RESERVATION FORM

EVENT: DATE:

START TIME:

ENDING TIME:

ADDITIONAL TIME: Will additional time be needed for set-up or take down? How long:

DESCRIPTION of ACTIVITY: SPONSORING ORGANIZATION: CONTACT PERSON: ADDRESS: CITY/STATE/ZIP PHONE (h) PHONE (w)

FACILITY REQUESTED (Bold all that apply) - Church - Schindler Hall - Celtic Center / Gym - Cafeteria - Commons Other Room(s): Estimated number of guests / participants:

EQUIPMENT REQUESTED:

EVENT INFORMATION YES NO Will food or beverages be served? Will alcohol be served? If “yes,” see license requirements. Will there be a raffle or door prizes awarded? Will attendees be charged a fee? Will there be games involving cards, dice, or wheels? Will there be deliveries prior to the event / pick-ups after the event?

Listed below are the Fees / Charges. Confirmation will not be issued until a deposit of 50% has been received. Balance Due on or before the date of the event. See reverse for rules regarding the refunding of the Cleaning Charge / Damage Deposit and cancellations.

FEES / CHARGES AMOUNT DEPOSIT BALANCE Room / Facility Use Charge Equipment Use Charge Cleaning Charge / Damage Deposit Other TOTAL The undersigned acknowledges that he / she has read and will comply with the rules and provisions contained on both sides of this agreement.

By: ______Date: _____/______/______OFFICE USE ONLY Form Revised 7/06 Date Submitted: ____/____/____

Event Approved: Yes / No PDS – FACILITY SCHEDULER: Date Entered ____/____/____

By: ______TERMS AND CONDITIONS OF THE AGREEMENT

1. RELEASE: In consideration of “permissive entry and use” of the designated facilities for the described activity, the use, their representatives, heirs, and assigns, do hereby release, discharge, and covenant not to se The Catholic Community of St. Patrick (Parish) and the Archdiocese of Louisville (Archdiocese) for any and all claims and liability arising from the use of these facilities. Furthermore, the user agrees to indemnify and hold harmless the Parish and Archdiocese and their employees from any claims, judgments, or expenses incurred by or the result of this activity. The user agrees to provide The Catholic Community of St. Patrick with an insurance liability certificate naming The Catholic Community of St. Patrick as an additional insured for the amounts listed below. Special event insurance may be purchased through the Parish for a nominal fee.

MINIMUM GENERAL LIABILITY COVERAGE: $1,000,000.00 MINIMUM HOST LIQUOR LIABILITY COVERAGE: $1,000,000.00

2. USE and CONDUCT: The user covenants that the facilities will only be used for the described activity during the time(s) allotted and will vacate the premises upon request by the Parish. The user further understands that it is his or her responsibility to: Arrange for the opening and closing of the room or facility Have someone available to receive deliveries and handle returns or pick-ups Ensure that all equipment is used and returned in the same condition as received Provide adequate supervision for all minors, minimum ratio of 1 adult per 6 children Police the conduct of the event and its participants Ensure that Food and Drink are kept in designated areas Ensure that facilities are cleaned and returned to their original condition or state St. Patrick retains the right to reassign the activity to another facility should the need arise.

3. ALCOHOL USAGE: The user is responsible for obtaining the proper State and County Liquor Licenses to serve or sell alcohol. The user agrees to abide by the laws governing alcohol usage and provide the required insurance coverage for “Host Liquor Liability” as outlined in Item #1 above.

4. CHARITABLE GAMING – RAFFLES – GAMES OF CHANCE: The user agrees that it will not conduct any type of gambling, raffle, or game of chance during the event. Parish organizations wishing to conduct such activities must fill out a Fund-Raising Request and submit it to the Stewardship Committee for approval at least 90 days in advance.

5. FOOD SERVICE: Individuals requiring the use of the kitchen or concession stand agree to complete the necessary check list with that facility’s manager.

6. EXPENSES: The user covenants that it assumes liability for all bills, invoices, and expenses related to the described activity, including, but not limited to, additional charges by St. Patrick for clean-up or damages.

7. FEES / REFUNDS: A 50% Deposit is due at time of reservation. The Balance is due on or before the date of the event. A full refund will be given for written cancellations received 30 days before the event. A refund of only the Cleaning and Damage Fees paid will be made

OFFICE USE ONLY Form Revised 7/06 Date Submitted: ____/____/____

By: ______for written cancellations received less than 30 days before the event. Please allow 30 days for processing refund requests.

8. POLITICAL EVENTS: Federal laws prohibit the use of Parish facilities for partisan political events.

OFFICE USE ONLY Form Revised 7/06 Date Submitted: ____/____/____

By: ______