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Name of Contact Person: _________________________________
Company Name(if applicable)_____________________
Address: ______________________________City_______________________State________Zip_________
Phone: (Home) _________________________(Work)___________________E-mail________________________
Date of Lind House usage: ______________________________
Specific Times of House use_____________________
Type of function: _______________________________________________________________________________
Estimated number of persons attending: ____________
Will you require the use of the handicapped elevator?________
Will food be served ? Yes _______No _________Caterer ______________Will bring our own food_____
Informal Gathering _____________ Sit down meal ______________
Will you need our staff to set up large round tables and chairs for a sit-down meal? __________
(additional fee of $20)
Will you need our staff to set tables with table linens, silverware, glassware, etc? ____________
(additional fee of $35)
If yes, please circle the additional items you want on tables:
wine glasses
water glasses
coffee cups
seasonal centerpieces
Will you need our staff to take down and put away the large round tables & chairs?_____________
(additional fee of $20)
Will you need our staff to set up & take down small tables & chairs for an informal reception?___________
(additional fee of $35)
Will you need additional services for a wedding?
(ceremony set-up, 2-day wedding package, decorations - see fee schedule)____________
Will you need a staff person to work in the kitchen during your event?_______________________
($12.50 per hour)
Included is my check for the entire amount of house usage. Please refer to Fee Schedule sheet.
House Rental __________________ plus set-up/take down fees______________plus wedding services fees___________________
plus staff person fees @ $12.50 per hour _____________plus refundable $100 damage deposit________. Total Enclosed_________
The damage deposit will be returned within 30 days of usage.
If damage occurs, staff will contact responsible party and determine charges.
Cancellation Policy: Full refund of deposit if cancelled at least 30 days prior to the scheduled event.
Signature of User: ________________________________________________
Date: _______________________
A copy of this contract will be signed by staff and returned to responsible party.
Signature of Executive Director: ____________________________________ Date:_______________________
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Need A copy - We offer you two differant formats MS Word and Adobe Acrobat
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Be a Guest at your Own Party!
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