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Rosenwald Request Form

  1. Waynesboro_PR_4C
  2. Rosenwald Request Form

  3. Rosenwald Entrance
  4. Applicants Information- Applicant must be the contact person responsible for the event
  5. Provide a brief description of the event.

  6. Area of Rosenwald:*

    Check all rooms you plan to use.

  7. Is your event?*
  8. Admission/Entry Fee:*
  9. No. of Adults Expected:*
  10. No. of Children Expected:*
  11. The following terms are agreed to by the applicant:

    I have read and understand the following guidelines to reserving Rosenwald Community Center.

  12. The event will be properly supervised by adults 18 years and older.*
  13. The applicant is responsible for for providing adequate supervision. The number of required adults will be determined by the Director of Parks and Recreation.*
  14. Applicant MUST leave the area in the condition he/she found it. A clean-up deposit may be required depending upon the nature of the event. Please do not use markers, sprays, etc. to write on walls, doors or windows. If decorating for an event, remove all such decorations and any tape used from all areas. Restitution will be made by the applicant for any property damage.*
  15. People will not be permitted to block exits.*
  16. Smoking is NOT permitted in the community center.*
  17. Appropriate shoes per activity MUST be worn by anyone entering the gym or exercise room.*
  18. Drinks, food and chairs are not permitted in the gym or exercise room without prior written permission.*
  19. Alcoholic beverages are NOT allowed in the building or on the premises.*
  20. The Department of Parks and Recreation reserves the right to deny entrance to anyone suspected of being under the influence of alcohol or drug.*
  21. Exit doors in the gym and exercise room are for use as fire exits only – all persons are to enter and leave the building via the main entrance off the parking lot. *
  22. Gym capacity is 400 people. This figure is not to be exceeded.*
  23. Any amplified music may be monitored by a Waynesboro Department of Parks and Recreation employee who has sole rights to regulate levels.*
  24. Applicant assumes the responsibility of informing all those involved in the rental of the terms of this contract.*
  25. Applicant is responsible for providing adequate security for all events scheduled. The Department of Parks and Recreation reserves the right to require user to employ professional security services.*
  26. Type and amount of security provided must be approved by the Director of Parks and Recreation a minimum of five working days prior to event date.*
  27. Department of Parks and Recreation sponsored events will take precedence over all other requests for usage.*
  28. Parks and Recreation must be notified anytime you are not attending the event you have reserved the room for. This may be done by email parkandrec@ci.waynesboro.va.us or calling the office at (540)942-6735.*
  29. If the fire alarm sounds, the building must be evacuated.*
  30. This contract may be revoked if the terms of the contract are breached.*
  31. One signed copy of this contract must be returned to Waynesboro Department of Parks and Recreation within ten working days prior to the date requested, before a reservation can be made.*
  32. The Department of Parks and Recreation reserves the right to grant or deny any requests*
  33. This is not meant to be an all-inclusive list of all rules associated with the use of a City of Waynesboro, Department of Parks and Recreation facility. The Department of Parks and Recreation reserves the right to amend these policies when it believes it is in the best interest of the citizens of Waynesboro to do so.*
  34. Fees:
  35. Payment of rental fee is due in full prior to the permit being granted. Payment shall be made in the form of cash or check payable to the Department of Parks and Recreation.

    Fees are as follows:  

    $20.00 per hour rental fee for 1-room;

    $30.00 per hour combo fee for 2-rooms;

         (example: Gym & Party Room)

    $50.00 Fee for use of the Kitchen

  36. WAIVER OF LIABILITY:
  37. I, the undersigned renter, agree to follow the regulations set forth in the Waynesboro Department of Parks and Recreation’s Rosenwald Community Center Request for Use of Facility Document which I have read and fully understand.

    Furthermore, as the renter of this facility, I intend to be legally bound for myself, my heirs, executors and/or administrators. I therefore waive and release any and all rights and claims for damages I may have against the City of Waynesboro, Virginia, the Waynesboro Department of Parks and Recreation and their officers, agents, representatives and assignees, for any and all liabilities, losses, damages or injuries suffered during or as a result of my rental of this facility.

  38. Leave This Blank:

  39. This field is not part of the form submission.