Date of Function: _______________________________________________

Requestor: Print name___________________________________________

Signature of requestor ____________________________________
Type / purpose of Function: ______________________________________ _____________________________________________________________

Member Status: Active_____ Non-Active_____Senior______Military_____

HALL RENTAL FEE

Circle one:

Active members: Non-Active Members:

$50.00 under 50 persons $100.00 under 50 persons

$100.00 over 50 persons $150.00 over 50 persons

Deposit: $100.00 Deposit: $100.00

TOTAL: $

Bar needed? Yes____ No____

Bartenders Needed? Yes____ Number: ______ No_____

Kitchen needed? Yes______ No_______

Police or security will be the responsibility of the Requestor.

Club members will vote at a regular meeting to approve or disapprove a hall rental.

NOTE: In addition to the rental fee, there will be a $100.00 deposit required when reserving the club for a function. The renter will be responsible for assuring that the club is restored back to its original condition or better. After inspection by one or more members of the board, the deposit will be refunded to the person renting. The person renting the club must attend the entire event for which the club was reserved.

Authorized By_________________________________________________