Barbecue Grill Request Form.Doc

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Charcoal Grill Reservation Form Any client (“Client”) of Cummings Properties, LLC (“CPL”) may borrow and use (at its own risk) a charcoal grill by submitting this request form to CPL. The grill is being provided as a courtesy only. CPL undertakes no responsibility for setting up, starting, operating and/or dismantling such grill, and Client knowingly and voluntarily waives, releases and agrees to indemnify CPL, its agents, employees, representatives, affiliates and any other person acting for or on behalf of CPL from and against any and all claims, demands, costs, expenses, damages, injuries, liabilities and causes of action whatsoever arising out of the use, handling, condition and/or operation of the grill. Client will provide the following items in connection with its use of the grill: · Grilling utensils · Grilling gloves · Trash bags/barrels · Charcoal (grill capacity: two 20-lb bags) · Charcoal lighter fluid and lighter/matches · Aluminum foil to cover the grilling surface WARNINGS: · Always use caution when lighting and using grill. · Grill frame and grilling surface get extremely hot. · Gloves are strongly recommended to be worn while grilling. · Grill must not be moved once the charcoal is burning. · Charcoal must be extinguished before Client leaves the grill area. · Follow all recommendations and instructions on charcoal bag and lighter fluid container. · Charcoal must not be dumped on the ground or in any CPL dumpster. Client must remove all trash and other materials used for grilling and the related event and properly dispose of same following use. By signing below, I, , on behalf of Client, ___________________________, located at , hereby accept and agree to the terms and conditions above. Client: By: Duly Authorized Print name: Reservation Request for: Date: Time: Location: : G:\SHARED\2_DOCS\LIBRARY\OPERATIONS\BARBECUE GRILL REQUEST FORM.DOC Corporate Office: 200 West Cummings Park, Woburn, MA 01801-6396 781-935-8000 Fax 781-935-1990 Cummings Center: 100 Cummings Center, Beverly, MA 01915-6106 978-922-9000 Fax 978-9229880 .

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