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Dorothy Hart Community Center Rental Request Form

  1. Dorothy Hart Community Center Rental Request Form
  2. Read our Dorothy Hart Community Center Rental Information (PDF) before completing the below rental request.

  3. Rental Representative
  4. Rental Information
  5. Room Requested (choose one)*
  6. In consideration for the use of City of Fredericksburg, VA property for myself and all my legal representatives, I do hereby agree and undertake to save and hold harmless, release and forever discharge the City of Fredericksburg, its officers, agents, employees and any and all other persons, firms and corporations, acting on behalf of the City from any and all actions, demands or claims for damages to persons or property, that may arise out of the use of said City property specified here, without regard to a negligent act or omission of the applicant, the City of Fredericksburg, or any other person, organization , firm, or corporation acting on behalf of the City.

    By my signature below, I certify that I have received a copy of, read, and fully understand my rental contract, the general rental policies, and the prescribed responsibilities for DHCC lessees. I further understand that my failure to meet any of these responsibilities or comply with any policy may result in the immediate termination of the rental agreement by the onsite facility supervisor. I also agree that, if termination of the rental agreement is deemed necessary by the supervisor, I will ask that my guests exit the DHCC in a quick and orderly fashion and personally oversee the clean-up of the rental space. Finally, I understand and agree that, should early termination of my rental contract become necessary, I will receive no refund of rental fees and my deposit may be withheld.

    Applicant has read and will abide by attached DHCC Rental Policy.

  7. Lessee Signature: I understand that checking the box below is the equivalent of signing my name.*
  8. Alcohol Policy and Contract

    A. Lessee is responsible to obtain all necessary, banquet special event or mixed beverage special event licensing from the Virginia ABC Board. Here: (http://www.abc.virginia.gov/licensing/obtainlicense.html)

    B. Lessee of the DHCC with alcohol permit is required to be covered by additional comprehensive liability special event policy in the amount of $1,000,000.00 in effect the dates of facility use listing the City of Fredericksburg as the named insured, which is to be submitted to the office 2 weeks prior to rental. Which can be purchased here: http://www.specialeventinsurance.com

    C. Lessee is required to pay an additional alcohol deposit to the current rental deposit fees. These deposits are refundable provided there is no damage and the area is returned clean.

    D. Lessee will pay an alcohol usage fee. This will cover any additional administrative time required to track permitting and scheduling, which is to be submitted to the office no later than two (2) weeks prior to rental.

    E. Alcohol will only be consumed in the rental area (DHCC) that is covered by the ABC permit. No alcohol will be permitted outside the rental area.

    F. Alcohol usages fees are NOT refundable even if all other fees are refundable. (i.e. cancellation)

    G. Lessee assumes responsibility for all guests that consume alcohol during their event.

    In consideration for the use of City of Fredericksburg, VA property for myself and all my legal representatives, I do hereby agree and undertake to save and hold harmless, release and forever discharge the City of Fredericksburg, its officers, agents, employees and any and all other persons, firms and corporations, acting on behalf of the City from any and all actions, demands or claims for damages to persons or property, that may arise out of the use of said City property specified here, without regard to a negligent act or omission of the applicant, the City of Fredericksburg, or any other person, organization, firm, or corporation acting on behalf of the City.

    By my signature below, I certify that I have received a copy of, read, and fully understand the alcohol policy and contract for DHCC rentals. I further understand that my failure to meet any of these responsibilities or comply with the policy may result in the immediate termination of the rental agreement by the onsite facility supervisor. I also agree that, if termination of the rental agreement is deemed necessary by the supervisor, I will ask that my guests exit the DHCC in a quick and orderly fashion and personally oversee the clean-up of the rental space. Finally, I understand and agree that, should early termination of my rental contract become necessary, I will receive no refund of alcohol fees and my deposit may be withheld.

  9. Please initial the following statements

    I have read and I understand the contract for renting a room in the Dorothy Hart Community Center.

  10. Leave This Blank:

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