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| Building Rental Form |
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| The CAGE |
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| 4484 S. St. Rd. 19 |
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| (765) 675-7947 |
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| www.thecagetipton.com |
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| Today's Date |
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office use
only |
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| Name |
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Date Received |
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| Address |
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Deposit Received |
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Check # |
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| Phone |
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Balance Due |
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| Cell # |
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Date Balance Paid |
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| E-Mail |
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Check # |
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| Date
of Rental |
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Time Requested ____________ until _____________ |
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| Purpose
of Rental
_____________________________________________ |
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| The
Sideline Café has seating for 36. If you need seating for more than that, indicate needs below: |
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| Equipment
Needed: |
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Indicate How Many |
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| Banquet
Tables |
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| Chairs |
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| Other |
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| ******************************************************************************************* |
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| Sideline
Café Rental @ $ 20/hour |
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___________ |
Must rent for at least 1 hour. Food, presents, birthday cake done in this
area. |
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| Gym
court rental @ $ 25/hour per court |
___________ |
At least one court must be rented
for entire time party is booked. |
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| Batting
cage rental @ $ 10/half-hour per cage |
___________ |
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| Hot
dog, chips, drink ($2.50 per person) |
___________ |
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| TOTAL |
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___________ |
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| *I/we do hereby acknowledge, recognize and accept the inherent
risk of bodily injury, disability, paralysis, and/or death to
myself/ourselves and my/or my/our children that exists as a result of |
| my/our
participation in any athletic endeavor, and specifically, by my/our
participation in athletic endeavors offered or hosted by The CAGE. As such, I/we do hereby agree to save, hold |
| harmless,
and indemnify The CAGE, its owners, employees, agents, and other individuals
or entities operating on behalf of The CAGE, for any bodily injury,
disability, paralysis, and/or death, that |
| I/we
and/or my/our children may sustain as a result of my/our participation in any
athletic endeavor offered by The CAGE. |
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| In
the event that I/we or my/our children suffer some type of injury or illness
which requires immediate medical treatment, I/we do hereby consent to and
authorize the administration of such |
| first
aid and/or medical treatment to myself/ourselves and or my/our children by
employees and/or agents of The CAGE trained to administer such first aid
and/or medical treatment. I/we do |
| further
consent to and authorize employees and/or agents of The CAGE to arrange for
ambulance transportation for an appropriate medical facility for me/us and/or
children. |
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| Signature
___________________________________________ |
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