VILLEBOIS COMMUNITY CENTER RESERVATION FORMS ATTACHMENT 1 HOLD HARMLESS / LIABILITY AGREEMENT The Villebois Community Center (VCC), its directors, agents, officers, and employees assume no responsibility for the personal property of anyone using the Community Center during times of reserved use. The Contract Holder will remove all property from the premises at the conclusion of the reserved use unless prior arrangements have been made. The Contract Holder and all users of the Community Center during the time of reserved use will be responsible for the adherence to Villebois Community Center Association (VCCA) legal documents, including all amendments thereto, and all specifications of the Contract. It is understood that the Contract Holder agrees to indemnify the VCCA, its directors, officers, agents, and employees, and hold them harmless from and against any and all liability, damage, expense, cause of action, suits, claims or judgments arising from injury to person or property occurring in or about the premises and upon the adjoining sidewalks, streets, or ways which may arise from the VCCA ownership of the premises, from any action or omission of the Contract Holder, its agents, employees, invitees, or licensees, or from any cause whatsoever. There is a pre-use and post-use walk through inspections of the Community Room by a community volunteer. After the event, it is the Contract Holder s responsibility to ensure the Community Room is cleaned in accordance with the Community Room Check List. A cleaning fee, based on the current janitorial contract, may be assessed if the checklist has not been followed. SIGN-OFF: I have received and reviewed the Villebois Community Center and Pool Policy and Rules. Print Full Name: Signature: Date: April 2016 1
VILLEBOIS COMMUNITY CENTER RESERVATION FORM ATTACHMENT 2 APPLICATION FOR USE Please review all regulations pertaining to the use of the Villebois Community Center prior to completing application. Date of Application: Contract Holder Name/Responsible Party: Organization: Address: Telephone number(s): Email: Key FOB #: Name(s) of Additional Individual(s) for entry: (Up to two additional key Fobs) Key Fob(s) #s of Additional Individual(s) Authorized for Entry: Event Date: Start Time: End Time: (Start & End Times must include set-up and break down/clean-up time) Is it a (as defined in rules): Community Event Private Event Public Event Reoccurring event (see definition in rules): Yes No If yes, please list all dates requested: Describe the proposed activity in detail: Number of individuals expected to participate: April 2016 2
The information on page 2 is true and accurate to the best of my knowledge. I agree that I have received a copy of the Villebois Community Center and Pool Policy and Rules and have read and understood those rules and regulations and agree to abide by them. I further agree by my signature below that approval of this application shall be subject to the sole discretion of the VCCA, that any activities permitted hereby shall be limited to those listed on the application and that the VCCA may terminate this agreement on 24-hours notice in case of gross negligence by applicant and upon 10 days notice with or without cause. APPLICANT: Date: By: (Signature) (Print full name) Send/Fax/Email Completed Forms To: Community Management Inc., AAMC c/o Jennifer Martin 2105 SE 9th Ave Portland, Oregon 97214 P: 503-445-1226 F: (503) 233-8884 VCCA_rental@ourvillebois.com April 2016 3
VILLEBOIS COMMUNITY ROOM CLEAN-UP CHECKLIST ATTACHMENT 3 In order to keep our Community Room beautiful, clean and in order for all, please complete, date and sign the following checklist at the end of your event. Leave this form in the first drawer in the marked folder. ** Cleaning supplies are located under the sink and in the cabinet to the right of the refrigerator. The broom, mop (Swiffer Wet Jet) and vacuum can be found in the janitor s closet. The janitor s closet key can be found in the top drawer to the farthest left of the dishwasher. Kitchen Refrigerator - All the food, including liquids, need to be removed and any spills and/or food debris wiped out of the inside. Wipe any spills or smudges from the exterior of the refrigerator. Stove - Please ensure the oven and all burners are turned off. Any spills in the oven need to be cleaned. Also please ensure the cook top and oven door are wiped down/cleaned. (If needed, glass stove top cleaner is located in the cabinet to the right of the refrigerator.) Exhaust Fan/Hood - Please turn the exhaust fan and light off. Please wipe down/clean the exhaust hood. (Per ADA regulations, the exhaust fan and light switches are located on the wall just right of the stove.) Sink - The sink must be cleaned and free of any grease/food; this includes the garbage disposal. Microwave - The microwave should be wiped down/cleaned inside and out. Dishwasher - If dishes are placed into the dishwasher, be sure to run it before leaving; time permitting, please put the dishes away in the proper place. Wipe any spills/smudges from the exterior of the dishwasher. Countertops - All countertops should be wiped down/cleaned. Cabinets/Drawers - Any spills onto/into the cabinets/drawers should be wiped up/cleaned right away. Trash - Make sure all trash and recycle are disposed of and put into the garbage cans. The lids need to be fastened tight. (Please be sure to tie the liner before placing it into the can. Also please be sure to replace the liner for the kitchen trash/recycle.) Kitchen Floor - Sweep and mop the floor. (Broom & Swiffer Wet Jet (mop) are located in janitor s closet. The Swiffer cleaning pads are located under the sink or in the cabinet to the right of the refrigerator). April 2016 4
Living Area Carpet - The carpet in the Community Room & Entry Hallway needs to be thoroughly vacuumed. The vacuum is in the janitor s closet. Any spills or spots need to be cleaned up. (If the Conference Room was also used, please vacuum this area as well.) Vacuum - Upon completion of vacuuming, please empty canister. Furniture - All furniture needs to be free of crumbs or spills and placed back in its original setting- please refer to the Community Room Furniture Layout section of the Community Room Handbook. (Handbook can be found in the top drawer left of the dishwasher.) TV and associated electronics - Should be turned off. Remotes should be returned to top of cabinet beneath TV. Windows and Doors - All should be cleaned of fingerprints /markings. Leave blinds open. Ping Pong Tables - Should be folded and placed back according to the furniture layout. Please place the equipment into the cabinet below the TV. Foosball Table - Any spills should be cleaned right away, please also clean any debris or smudges. Please return the Foosballs to the holder on the Foosball Table. Folding Tables and Chairs - They need to be wiped clean and returned to the Game Room closet. Signage - If enter using side door signage was used, please return it to the top drawer farthest left of the dishwasher. Janitor s Closet - Please double check to ensure the light and fan in the closet are turned off and ensure the door is locked. Janitor s Closet Key - Should be returned to the top drawer farthest left of the dishwasher. Bathrooms - Walk through the bathrooms and tidy up. ***Once all items have been checked off/completed, please sign and date the form. Note: Items left behind will be donated after one (1) week. PRINT FULL NAME: SIGNATURE: DATE: April 2016 5
VILLEBOIS COMMUNITY CENTER RESERVATION FORM Attachment 4 SPECIAL REGULATIONS A reserved Community Room Event does not allow access to the pool. Attendees may not enter the pool area. Pool users who wish to attend a Community Room Event must dry off and change first. A reserved Community Room event does not allow access to the Fitness Room. Attendees may not use the fitness room or the equipment. Alcoholic Beverages may be permitted provided that the attendees agree to abide by all Oregon State and local Wilsonville laws. The Contract Holder is responsible for reading, understanding and abiding by the Villebois Community Center and Pool Rules regarding consumption of alcohol on the premises. No alcohol may be served to any guest who is under the age of twenty-one (21) or who appears intoxicated. Alcohol may only be served and consumed in the Community Room. The sale of alcohol is strictly prohibited. Service of alcohol will end at least one hour prior to the scheduled end of the reserved use. A designated driver system should be used as the case warrants. I have read, fully understand and accept the special rules related to the serving/consumption of alcohol in the Villebois Community Center. Print Full Name: Signature: Date: April 2016 6
VILLEBOIS COMMUNITY CENTER RESERVATION FORM EXHIBIT C SPECIAL RULE PROVISIONS FOR FACILITY USE The Community Room may be reserved for a private sleepover party under the following conditions: 1. Contract Holder must be present at all times. 2. Youth 17 years of age or younger must be chaperoned. 3. Party is contained to the Community Room only, no loitering in the hallway or bathrooms. 4. No pool or fitness room use/access is allowed by attendees at any time. 5. Failure to comply with the above provisions will result in suspension of Community Center privileges. 6. All other general rules and policies must be followed at all times. I fully understand and accept the special rule provisions related to hosting a youth sleepover event in the Villebois Community Center. Print Full Name: Signature: Date: April 2016 7