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2. Choose your Facility*
   -- Select One --Golf Course Reception HallMLK Event Center

   Choose one

4. Name*
5. Email Address*
7. Address*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
14. Work Number
16. Date of Rental*
17. Start Time*
18. End Time*
20. Type of Event*
    -- Select One --PublicPrivate
21. Average Age of Guests
22. Expected Number
24. Event Description*

26. For problems during regular business hours: 337-239-2444             After hours: 337-239-7950

28. Facility Rental Policies:

    Fees:

    • Cost is $250.00 per day. All fees must be PAID IN FULL at LEESVILLE CITY HALL prior to the start of the event. There will be no exceptions to this fee, EXCEPT in cases where the City of Leesville is the primary host. 
    • A minimum deposit of $100.00 is required when making the reservation. This deposit will be used toward the final rental fee. 
    • There is also a $75.00 REFUNDABLE Security Deposit – The entire security deposit will be refunded after conclusion of the event, provided the facility is clean and has been returned to its original state. We would prefer to have a separate check which can be returned uncashed after the event has concluded. 
    • For credits, refunds, or changes to rental period, notification must be received by the facility manager no later than 5 days prior to scheduled rental, otherwise the rental deposit ($100) will be forfeited.
    • Responsibility for any damage to facilities resulting from usage beyond normal wear/tear will be assumed by the individual, group, or organization reserving the facility.

    Facility Rules:

    • The City of Leesville will provide tables, chairs, refrigerator/freezer, stove/oven, trash cans with liners and stocked rest rooms. 
    • PLEASE DO NOT USE THE ROUND TABLES WHEN COOKING OR PREPPING MEALS, YOU MAY USE THE RECTANGULAR TABLES THAT ARE PROVIDED.
    • Use of table coverings is required when using the round tables.
    • Set-up and clean-up of the facility is the responsibility of the renter, and everything must be returned to its original state at the conclusion of the event. 
    • You may decorate as desired, but you will be charged for any damage to equipment, building structure, and/or fixtures. Do not hang items from the ceiling and/or ceiling fan.
    • Food and non-alcoholic drinks may be brought in for the event. Renters must also supply any necessary dishes, utensils, tablecloths, etc. 
    • All paper and waste shall be deposited in trash receptacles in order to keep facility neat and clean. 
    • At the conclusion of the event, all trash should be removed to the dumpster outside the building. This includes cigarette butts and trash that may have been dropped outside the building.
    • Brooms, mops and buckets are available, but cleaning solutions will not be provided. 

    Additional:

    • All minors must be under adult supervision at all times.
    • NO ALCOHOL or WEAPONS are allowed on the premises.
    • NO SMOKING inside buildings.
    • NO INFLATABLES, nor anything else requiring extension cords, water hoses, or excessive use of water/electricity.
    • NO PETS inside buildings, with the exception of Service Animals.

    Securing the Facility After Conclusion of your Event:

    • The event must be completed and the facility vacated within the specified time as indicated on the contract, ending no later than 11:00 pm. 
    • Renter should ensure that no personal items have been left behind, including food and drink in the refrigerator, as well as any decorations, clothing or other items, PRIOR to leaving. 
    • Renter should ensure that all participants have exited the building and that all lights, stove, oven, air conditioning, etc. are off before leaving. The facility should then be secured, with the key returned as directed. 

30. DO NOT SIGN BELOW UNTIL YOU HAVE READ THE ABOVE AGREEMENT.

    My signature below certifies that I have read, fully understand and accept all terms of the foregoing Applicant Statement:

32. I confirm that I am authorized to enter into this agreement.*

    1. I agree.
    2. I do not agree
33. If signing on behalf of a minor, I represent and warrant that I am the minor’s parent or legal guardian.*

    1. Yes
    2. No
    3. Not applicable
35. eSignature*

    Typing your name into this space serves as your legal signature on this document.

36. Date*
38. Below is for Office Use Only:

    Facility Cost: ________________________________

    Additional Cost (Amenities): _________________

    Total Charges Due: __________________________

    Rental Deposit (Min $100): ___________________                              Date Paid: ___________________

    Balance Due: ________________________________                              Date Paid: _____________________

    Security Deposit: $75.00           Date Paid:________________           Date Returned: ________________  

    
    

40. 
    

    Approved by City of Leesville Staff:   ____________________________________________________

    
    

    OFFICE CODES: Golf Course – 7345; MLK Center – 7400

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42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

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