Rental Request Form

* First Name:

* Last Name:

* Address:

City:

State:

Zip:

* Phone #:

* Email:

* Facility Requested:
---Northampton Community CenterNorthcrest Activity BuildingNorthcrest Pool Pavilion- South Side of PoolNorthcrest Pool Pavilion- West Side of PoolNorthcrest Pond PavilionWest Park Pier and PavilionInway Pool Pavilion

* Date Requested:

* Time Requested:

* Event Description:

* Approximate # Attending:

* Will alcohol be served?
YesNo

Comments:

Policies:

• No alcoholic beverages at any pool function.
• Smoking is prohibited inside of buildings.
• No firearms or fireworks allowed.
• No rice, glitter, confetti or piñatas in buildings or on park grounds.
• Nothing may be attached to walls, ceiling, or windows.
• Kitchen areas are for food distribution only. Food is to be covered dish or catered.
• Pets are not allowed except as necessary to assist the disabled.
• No red or purple drinks as they stain carpet.
• Fund raising activities are restricted to nonprofit basis and must have prior approval.
• Facility use is restricted to those activities designated in the original request.
• Facilities must be returned to the same condition as prior to the rental, and under any circumstances, clean and secured.
• Children under 18 years of age must be supervised at all times.
• Insurance which names the Northampton Municipal Utility district as additionally insured must be furnished upon the request of the board of directors.
• Tables and chairs are to be carried and not pulled across carpeted areas.
• At the conclusion of the event, a final check out sheet is to be signed by the party responsible for the event and any accidents or unusual events must be documented.

I agree to the rental policies listed above.
I am a Resident and accept full responsibility for the event requested.