Community Room Rental Request Organization Name Primary Contact * Street Address * City * State * Zip: * Phone * Email Brief description of your event: * Requested date and time of reservation (Available times are generally daily from 8 am – 5 pm. All reservations subject to availability.) * Do you need AV? * Yes No Payment Method * Cash Credit Card I certify that I am 18 years of age or older. * I am 18 years of age. I am not 18 years of age. I understand that, for a fee of $30/hour, Heart of the Valley will provide use of Spot’s Community Room and adjacent restrooms and kitchen, including the use of tables and chairs for a period of time as selected above. * I understand I understand that Heart of the Valley will not provide any food, drinks, or transportation for the event. * I understand I understand that smoking is not allowed inside Heart of the Valley, including Spot’s Community Room. * I understand I understand that access to the shelter facility will close at 5 pm, at which time all guests must vacate the shelter and the room must be cleaned and reset. * I understand I am responsible for ensuring that I will be present at all times while guests are present at the shelter. * I understand I understand that payment must be received prior to the event. * I understand I understand that a notice of cancellation must be given in writing at least 24 hours in advance of the date reserved. * I understand I agree to return Spot’s Community Room to a clean and orderly condition at the end of the event and to pay the cost for repair of any damages to the facilities. Heart of the Valley is not responsible for any materials or equipment left in the building. If the room is not left in satisfactory condition, a minimum charge of $100 will be levied. I will notify Heart of the Valley as soon as possible if I need to cancel the event so that the room can be made available to others. To the extent permitted by the law, I agree to protect, indemnify, defend, and hold harmless Heart of the Valley, Inc., and its respective employees and agents against all claims, losses or damages to persons or property, governmental charges or fines, and costs (including reasonable attorney’s fees), arising out of, or connected with my function, except those claims arising out of the sole negligence or willful misconduct of Heart of the Valley, Inc. In consideration of this agreement to rent Spot’s Community Room, I hereby for myself, my administrators, my heirs, and assigns, waive and release any and all right and claims for damages I have against Heart of the Valley, Inc., their associates and representatives. I also agree to exercise all safety precautions while using Heart of the Valley, Inc. property. By my signature below I verify that I am authorized to sign for and conduct transactions on behalf of the organization renting the premesis: * By my signature below I verify that I am authorized to sign for and conduct transactions on behalf of the organization renting the premesis: First Name First Name Last Name Last Name Today’s Date * Submit If you are human, leave this field blank.