HARRY J. MCDONALD MEMORIAL CENTER
COMMUNITY ROOM REQUEST FORM

Name of organization/individual:                                                   
Contact person:                                                                    
Address:                                                                           
Phone # hm:                      wk:                      fax:                   

1. Purpose of event and activities planned:                                        
                                                                                   
                                                                                   
                                                                                   

2. Date of event:                                           Time:                  

3. Number of people (approximately):                                               

4. Special needs:                                                                  

5. Is the event: by invitation only open to the public.

6, Will there be an admission fee for the event?

7. Organization type:

As the responsible party requesting the use of this room, I agree that the members of my group will abide by the following rules:

1. Payment is required at the time of reservation. This agreement constitutes a reservation. If fees are to be refunded, at least two week written notice will be required for all cancellations. Failure to notify the Center of cancellation will not relieve applicant of financial responsibility established by the request.

2. The Community Room is to be picked up after using it. The Center's staff will check the room for damages or excessive clean up. Anything spilled on the floor or tables will be cleaned up immediately. Do not serve RED colored drinks such as punch or Kool-aid. NOTE: All cleaning or repair of damages will be based on time and materials at $75.00 an hour with a $75.00 minimum charge.

3. Children are to be monitored at all times. They are not to be running around in the building.

4. Do not use tape, staples, or glue to place signs and decorations anywhere in the building without prior approval.

The undersigned representative of the organization which is applying for permission to use meeting room facilities has received the Facility Rules and Regulations. User agrees to save, hold harmless and indemnify the Harry J. McDonald Memorial Center and the Municipality of Anchorage from any claims; lawsuits of judgments arising from loss, damage to property or injury to persons from or during the above described activity(s).

Signature: ________________ Date:_________________