test pattern Community Center RentalsPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Today's Date *Resident Name (Contract Holder) *FirstLastResident Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateResident Email *Phone * Applicant of Alcohol Start Date / Time *DateTimeEnd Date / Time *DateTimeDescription of Event *Number of Attendees *Will Alcohol be Served? *YesNoThis includes any spirit (wine, beer, liquor). If answered yes, then a Host Liquor License will be required for renter to purchase and submit a Certificate of Insurance (COI) per the contract. *Agreement for UseThe above information is true and accurate to the best of my knowledge. I agree that I have received a copy of the Agreement for Use of the Community Center by Residents 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 Broadlands Association, that any activities permitted hereby shall be limited to those listed on the application, and that the Broadlands Association may terminate this agreement within a 24-hour notice in case of gross negligence by the applicant and upon a 10-day notice with or without cause.Applicant Signature * Clear Signature Submit Share this: Email a link to a friend (Opens in new window) Email Share on Facebook (Opens in new window) Facebook Share on X (Opens in new window) X
