Reservation Request

Bedford Area Welcome Center

Date of Request:______________

Venues(s): _____ Meeting Room _____ Main Gallery _____Terrace

Organization/Individual: __________________________________________________

Responsible Person/Contact Information: ___________________________________

_______________________________________________________________________

_______________________________________________________________________

Requested Dates & Times: ________________________________________________

Estimated Attendance: _________ Meeting Purpose __________________________

I, the undersigned, agree to act on behalf of the above organization and to be responsible for any damage sustained to the Bedford Area Welcome Center while being used by the above listed individual(s) or organizations. Furthermore, I agree to all conditions and policies set forth in the attached Bedford Area Welcome Center Building & Room Usage Policy. I hereby authorize Welcome Center to provide my name, phone number and related information, or that of a contact person, to any person inquiring about the above meeting.

I understand that the set-up and take-down for tables & chairs, cleaning, etc. is my responsibility. I agree the facility will be left in identical condition as when reserved and understand that all or some of the security deposit will be charged as deemed necessary to correct any deficiencies. As required by the policy, arrangements for the usage fee and/or security deposits must be made before this reservation is accepted. Cancelled reservations will result in a 10% penalty from the Security Deposit. Cancelled reservations due to building closure due to extreme weather will not result in a penalty.

I agree to the above procedures and have received a copy of the Building and Room Usage Policy:

Responsible Person: ________________________ ________________________________

(Printed Name) (Signature)

Phone: _____________ Day ______________ Evening _________________Cell

RESERVATION BY INDIVIDUALS (PRIVATE) & FOR-PROFIT ORGANIZATIONS

Room Fee ____ Hours x Hourly Rate

Security Deposit (Equal to 100% of the Room Usage Fee)

Total Fees Paid to Reserve Meeting Room

RESERVATIONS FOR CHARITABLE PURPOSES & NON-PROFIT ORGANIZATIONS

Payment of Security Deposit

A Room Usage Fee and/or Security Deposit in the amount of $________ has been received from the organization/individual listed above: _________________________________________

Authorized Welcome Center Representative

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