Village of Cornwallis CLUBHOUSE

Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date *

*30 Day notice required, certain holiday periods may be blocked. Exceptions may be made by calling office.

MM

DD

YYYY

Location *

Pool area only available during operating season. Area is closed when pool is closed.

Indoor

Pool Area

Both

Entry Time *

Not earlier then 12:00 PM (noon) the day of the event

Hour

Minute

Second

AM PM

Finish Time *

Event must end by 12:00 AM (midnight) and doors must remain closed at all times.

Hour

Minute

Second

AM PM

Music Source *

Play time no later then 11 PM

Boom Box

None

CLUBHOUSE RULES *

ALL TRASH MUST BE PUT IN THE DUMPSTER IN PARKING LOT. THIS INCLUDES TRASH FROM THE EVENT AND ALSO ANY TRASH IN THE SURROUNDING AREAS AND PARKING LOT AND POOL AREA. PARKING MUST BE IN THE CLUBHOUSE PARKING LOT OR ON YORKTOWN. NO PARKING ALLOWED IN BALFOUR EAST OR WEST COMMUNITIES.

I Agree

FEES *

Description of fees: Security Deposit - $150.00 Homeowner / Resident Usage - $125.00 Additional Pool Monitor - $13/hour - (*To be determined by management. Pool monitors are not lifeguards) Cancellation Fee - $125 (Cancellation notice must be given 7 days prior to event or rental fee will apply.) DEPOSIT & RENTAL FEE MUST BE RECEIVED IN MANAGEMENT OFFICE WITHIN 10 DAYS OF BOOKING DATE OR DATE WILL WILL BE RELEASED, NO EXCEPTIONS. 2 CHECKS ARE REQUIRED - $125 & $150. $150 CHECK WILL BE HELD & RETURNED AFTER APPROVAL FROM INSPECTION. Damages will be determined based on actual repair costs.

I Agree

*

Use of this form implies no agency relationship between the Home Owners Association and any Lessee. Lessee is in no way, shape or fashion an agent of the Home Owners Association. Lessee agrees to make no unlawful or offensive use of the premise. Lessee further agrees that they shall indemnify and hold Lesser harmless against any and all claims, demands, causes of action, suits at law or judgments (including any and all court costs or attorney’s fees) related to Lessee’s specifically acknowledges that Lessee is solely responsible for the actions of guests who attend Lessee’s function during Lessee’s use and occupancy of said premises in addition to the trip home. Lessee acknowledges that they are not acting as Lessee’s agent, employee or independent contractor and that Lesser will not be monitoring the Lessee’s guests’ use of alcohol or state of sobriety. Use of the clubhouse is solely at Lessee’s risk and liability. In addition, Lessee hereby makes application to reserve and use the clubhouse and agrees to abide by all rules and regulations established by lesser. Lessee agrees to be at the clubhouse during any conversation relating to and event and at all times during the event. I have read, understood and agree to the above statements and information, and I agree to abide by all the rules published relating to the usage of the clubhouse.

I Agree

*

You will be contacted a few days before your function to walk through the clubhouse. If you are more than 15 minutes late for this appointment, there will be a $25 dollar charge and it will be taken out of your deposit.

I agree