Application for Use

 

Before completing this application, please review all of the rules and regulations for use of the pavilion. Please type the application when possible. Please note that all items must be completed. Incomplete applications cannot be processed.

 

Name of Individual or Organization:  ________________________________________________________

 

Address: _________________________________________________________________________________

 

City: _______________________   State: _______________________  Zip Code: _______________

 

If applicable, Federal Identification Number: ___________________________501c3#_________________

 

Phone #:_________________Fax #: _____________________    Email address:_______________________

 

Name of Individual responsible for clean up and damage prevention:______________________________

_________________________________________________________________________________________

 

E-mail __________________________Phone_________________________cell_______________________

 

Date of Event (Including the day(s) of the week): _______________________________________________

 

Time of Event (including set-up and clean-up): ________________________________________________

 

Number of people expected to attend event: ___________________________________________________

 

Type of Event:  ______  Public  ______  Private

If event is open to the public, will there be an admission charge or ticket required? ____Yes ____ No

                                   

Describe the proposed event in detail, including activities, set up, equipment, music, dancing, food and beverage, decorations, etc. If further space is required (especially for large or complicated events), please attach a separate sheet.

Purpose of event: _____________________________________________________________________

 

Detailed plan including timeline if appropriate: _______________________________________________

_________________________________________________________________________________________

           

Advertising, promotion, and marketing for this event: __________________________________________

_________________________________________________________________________________________

           

Do you wish to display or distribute handbills, leaflets, or other printed materials?  Yes _____ No _____

 

If yes, please attach a copy. Do you agree that such materials will only be distributed if expressly requested without prior offer or solicitation? Yes _______   No ________

 

Beneficiary of proceeds if appropriate: __________________________________________________

 

No alcoholic beverages are permitted on site unless approved by the City of Manassas. **

Would you like to be considered for permission for alcoholic beverages? Yes _______No ________

City Police require a security plan, i.e. who is bartending, who will assist with unruly guests, etc.

 

** Once permission has been granted by the City of Manassas, the event organizer will need to obtain the appropriate permit from the Virginia Department of Alcoholic Beverage Control. A copy of the permit must be provided to the Manassas City Police and the City’s Management Company at least 30 days prior to event.

 

Rental Fees:

All Rental fees include an extra 2 hours setup time and 1 hour clean up time.

Additional hours may be purchased at $250.00 per hour

City resident or non-profit group:

$250.00 for 6 hours $350.00 for FULL DAY                                            $_______________

 

Non-City residents:

$500.00 for 6 hours $750.00 for FULL DAY                                             $_______________

 

For Profit Organizations:

$750.00 for 6 hours $1,000.00 for FULL DAY                                          $_______________

 

Pavilion Staff Fee $50.00 per hour (up to 4 staff provided)             $_______________

(REQUIRED for ALL rentals, from setup to cleanup time)         

 

Number of Additional hours purchased ____________________   $_______________

 

Do you wish to rent any of the following items from the Pavilion?

If so how many?

 

The 16X24 foot stage $200.00.___________________                                          $________________                                                                                                                                      

48 inch round table tables - $7.00 each______________                                    $________________

Linen table covers – $10.00 each_________                                                         $________________

Black wooden folding chairs - $3.00 each_______________                               $________________

 

Fee for Service items

Furniture set up fee & take down fee:
under 200 guests $350.00 , 200-300 guests $400.00 over 300 variable pricing. $________________

(Your group must remove trash and clear tabletops)

Pavilion employees clean up fee $200.00                                                              $_________________

(Pavilion employees will remove all trash and clear tables.)

 

Total Charges                                                                           $_________________

50% deposit received                                    Balance Due

with application____________________ 2 weeks prior to event                         $________________

 

SECURITY DEPOSIT OF________________RECEIVED

And held in file, to be refunded after the event if no damage occurs.

                                                                                                                  Insurance Carrier's

INSURANCE CERTIFICATE RECEIVED Date: __________________ phone_____________________

 

HOLD HARMLESS ARGEEMENT SIGNED & RECEIVED Date:___________________________

The above information is true and accurate to the best of my knowledge, and I expressly represent hereby that I have the authority to bind the organization by my signature below. In signing below, I agree that my organization has received a copy of the Loy E. Harris Pavilion Rules and Regulations, has read and understands these rules and regulations and agrees to abide by them. I further agree by my signature below that approval of this application shall be subject to the discretion of the City's Management Company and the City of Manassas, that any activities permitted hereby shall be limited to those listed on the application, and that the City's Management Company may terminate this agreement with or without cause at any time prior to or during the event. In the event of cancellation, Applicant agrees to limit the City's and RMSC's liability to the amount of the application fee. I further agree that I shall be responsible for obtaining all necessary permits and approvals required under Federal, state or county laws, ordinances, rules or regulations in advance of exercising the privileges granted hereunder and will make available for inspection any permit granted by the City's Management Company or by any governmental body or agency during all times in which the activities are being conducted.

 

APPLICANT:

 

Date: _______________________   By:             _____________________________________________

                                                                        (Signature)

 

_____________________________________________

(Print name)

 

 

 

The following additional items shall be included with this application:

 

_____ An executed agreement by you to indemnify and hold harmless the pavilion and the pavilion owner (form attached).

 

_____ A Certificate of Insurance shall be issued and specifically name as additional insured: "The City's Management Company and the City of Manassas, Virginia". Such certificate shall include "per occurrence" limits of at least $1,000,000 with $2,000,000 per aggregate limit. Check with your homeowner or business insurer to see if they can provide the one day Certificate of Liability insurance. The insurance certificate must be received by The City's Management Company at least thirty days prior to event. .

 

____ A security deposit must be made with certified funds by check, cashier’s check or cash, payable to the RMSC in the following amount:

 

_______$250.00 for up to 500 people                      ______$500.00 for up to 1,000 people

 

_______$750.00 for up to 1,500 people                   ______ $1,000.00 for up to 2,500 people

 

The City's Management Company and the City of Manassas reserve the right to require a higher security deposit depending on the number of people expected to attend and/or the nature of the event. This check shall be reserved against any clean up and/or security costs which may be incurred. This deposit will be returned to the individual at the address contained above if this application for use is denied or will be returned within ten (10) business days after any permitted activity has been completed.

 

_____ Any handbills, leaflets, signs, banners, displays, or other items proposed to be distributed, displayed, or made available shall be submitted with this application. The City’s Management Company reserves the right to deny any application involving handbills, leaflets, signs, banners, displays, or other written or printed materials or times which the City’s Management Company deems to be profane, indecent, disturbing, offensive, in poor taste or otherwise not conducive to the environment of the City of Manassas, Virginia.

 

 

 

 

RELEASE AND INDEMNIFICATION AGREEMENT TO USE MUNICIPAL FACILITIES FOR A PUBLIC OR PRIVATE EVENT

 

 

FOR AND IN CONSIDERATION of the City of Manassas permitting the use of public property, surrounding grounds including the gazebo and flatbed car, grounds and/or property (municipal facilities) for either a public or private event, I/we, the undersigned applicant and authorized event coordinator, ________________________________, do forever release and covenant to hold harmless the City of Manassas, Rink Management Services Corporation and their employees, representatives and agents from any and all claims or causes of action for injuries, costs, expenses, including reasonable attorney's fees, or other damages which I/we or my guest or invitees may hereafter have as a result of the use of a municipal facility or facilities for a public or private event whether or not caused or contributed to by any negligence or alleged negligence on the part of the City of Manassas, Rink Management Services Corporation, its agents or employees.

 

I/WE FURTHER PROMISE to bind myself/ourselves, my/our heirs, administrators, and executors to repay to the City of Manassas, Rink Management Services Corporation and their employees, agents and representatives any sum of money that it/they may hereafter be compelled to pay in any way connected with the said use of a municipal facility or facilities pursuant to this Agreement.

 

IT IS UNDERSTOOD that the City will not supply equipment that may be needed for this event, use or activity.

 

I/WE CONSENT to the above conditions.

 

I/WE FURTHER STATE that the foregoing Release and Indemnification Agreement has been carefully read and I/we know of the contents thereof and have signed the same by my/our own free act.

 

 

CAUTION: READ BEFORE SIGNING BELOW

 

 

___________________________________              ________________________________________

Name of Event Coordinator (Printed)                        Signature of Event Coordinator

 

 

___________________________________              ________________________________________

Municipal Facility or Facilities Permitted                  Date and Time of Authorized Use