Form Center

2. Renter:

   Person renting Civic Center

3. Rental Fee
   -- Select One --$20.00 (Non-Alcohol/4 hours weekday)$40.00 (Non-Alcohol/All day)$50.00 (Alcohol/4 hours weekday)$100.00 (Alcohol/All day)

   Please select one.

5. Rental Date:
7. Rental Hours

   List hours civic center will be used ie. 4-6 pm

9. Purpose:

   Example: Wedding/baby shower.  Party. Reunion...etc

11. Terms of Agreement
    1. The Rental Fee must be paid within ten days of the reservation.  Rental fees are refundable up to 30 days prior to the reserved date.  If the reservation is made within 30 days of the reserved date the rental fee is refundable within one working day of the date the reservation is made.
    2.  A cleaning, damage, & key deposit is due at the time the key is picked-up and may be forfeited if the building is not left clean, trash picked up, or the facility, furnishings or equipment is damaged. If the facility is left in satisfactory condition, the deposit will be refunded after completion of the inspection. Key must be deposited in the night depository at City Hall or turned into staff at City Hall during business hours immediately after completion of the event or deposits will be forfeited.
    3. The person responsible for the rental must be at least 18 years of age and that person must be on premises at all times.  The renter must provide proof that they are at least 18 years of age.
    4. No animals are allowed in the building at any time.
    5. The lessee for itself, its agents, employees, representatives, assigns and others using the Civic Center shall waive all claims whatsoever against the City of Girard, its Governing Body and representatives, for any loss, injury or damage during the time the Civic Center is used and occupied by lessee. 
    6. Lessee will be responsible for any damage done to the Civic Center or to the contents thereof during the time period the lessee has rented the building and will be responsible for any and all replacement and or repair costs associated with said damage. 
    7. The undersigned agrees to abide by all State and Municipal laws during the term of the rental.  
    8. The key must be picked up prior to the rental at City Hall during normal working hours, Monday-Friday, 7:30am-4:30pm. If the key is not picked up during normal working hours the rental fee will be forfeited. Under no circumstances will City personnel provide the key during non-working hours.
    9. Sanitation stations stay at the entrance. (If applicable.) 
    10. It is the lessee’s responsibility to abide by Federal, State, County and Local laws.
13. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your form will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
15. Electronic Signature
17. Address

    Renters address

19. City
20. State
21. Zip Code
23. Phone Number

    Person to contact regarding renting the center.

25. Email Address
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit Submit and Print

* indicates a required field