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Beacon Square Civic Association  3741 Bradford Drive  Holiday, FL 34691  727‐807‐7007 – Phone  727‐807‐7008 – Fax   

HALL RENTAL APPLICATION & AGREEMENT NAME OF ORGANIZATION___________________________________ PROFIT ____ NON-PROFIT___ REPRESENTATIVE NAME/INDIVIDUAL _________________________________ MEMBER – YES__ NO__ ADDRESS______________________________ CITY_______________ ST____ ZIP________ PHONE________________ MOBILE___________ EMAIL____________________________________ TYPE OF EVENT___________________________________________ DATE REQUESTED_______________ BEGINNING TIME (INCLUDE SETUP) ________________ ENDING TIME (INCLUDE CLEANUP)____________ AREAS REQUESTED – MAIN HALL_____ KITCHEN_____ # ITEMS REQUESTED – CHAIRS_____ TABLES_____ _____________________________________________ SIGNATURE ===================================================================

RENTAL FEES MAIN HALL - MEMBERS $50/HR ______

NON-MEMBERS $100/HR _____

KITCHEN

- MEMBERS $25

______

NON-MEMBERS $ 50

______

DEPOSIT

- MEMBERS $250

______

NON-MEMBERS $500

______

STAFF PERSON PAID DIRECT TO OPEN AND CLOSE @ $12.00 /HR

______

TOTAL FEES $_______________ DEPOSIT PAID $___________ DATE __________ CHECK #_________ BALANCE TO BE PAID 2 WEEKS PRIOR TO EVENT. DEPOSIT WILL BE REFUNDED AFTER THE EVENT. DAMAGES, CLEAN-UP, ETC WILL BE DEDUCTED FROM THE DEPOSIT AS NECESSARY. APPROVED BY _______________________________ BOARD MEMBER ACCEPTED BY _______________________________ REPRESENTATIVE/INDIVIDUAL

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