Application & Permit

 

Area/Facility Reserved _______________________________________________________

Group/Organization/Person in Charge ________________________________________

Address________________________________ Telephone No._______________________

Purpose________________________________ Number in Party_____________________

Date Reserved __________________________ Hours Reserved__________ to _________

The Township Facility may only be used my residents of Scioto Township. Scioto Township reserves the right to deny the use of the Township Facilities to groups who fail to comply with the rules and regulation set forth.

It is understood that the group or organization using the above designated facility will comply with the laws of the State of Ohio, the Township of Scioto and all the rules and regulation set forth by Scioto Township and :

Will be responsible for all persons in the group organization using the facility.

Assumes liability for any damage done to the facility

Will not use the kitchen unless a ladies auxiliary member is present

Will park only in designated areas.

Will observe all rules posted.

Will not allow ALCOHOLIC BEVERAGES in the facility.

Will be responsible for calls made from the Community center phone.


                                  Deposit - $50.00

                                   Refund - $50.00

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**Rental charge will be waived if activity is funeral related.

 

Refunds will depend on condition of building when inspected by the Service Director. If the building is clean and not damage in any way, money will be refunded after next scheduled township meeting.

 

*Policy Dept. has authority to enter Community Center at any time to check for violation.

* The Scioto Twp. Trustees reserve the right to cancel any application if necessary.

I have read and understood the above polices and regulations and agree to comply with them. For and in consideration of the permission to use the above described facility, I the undersigned, acquit, discharge and covenant to hold harmless the Township of Scioto, its officers, employees, servants, and agents of and from any and all actions, causes of action, claims, demands, damages, cost, loss of services, expenses and compensation, on or account of, or in any way growing out of, any and all personal injury or property damage which may result to group/organization members as a result of  participation in the aforementioned activity at the above described facility.

 

 

____________________________                                          ___________________________________                                                

                  Date                                                                             Signature of Person Responsible

                  

                                                                                                      ____________________________________

                                                                                                       Signature of Township Representative

Scioto Township

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Pike County