Keyfob Acquisition Agreement Form

Organization Name: *

Contact Name: *

Address: *

Primary Telephone: *

E-mail Address *

I hereby agree NOT TO LOAD OR DUPLICATE the keyfob provided to me by the Town of Cheverly for access to the Cheverly Community Center.
As duly authorized by the above named organization to accept this keyfob, I assume full responsibility for opening and closing the building for that group’s sponsored events, when a town staff member is not present.
I also understand that I may not use this keyfob to access the Community Center building for my own personal use, and that violation of this agreement will result in the repossession of the keyfob by the Town of Cheverly.

I understand that I MUST report the keyfob as lost or stolen within 24 hours. There is a $10.00 keyfob replacement fee which can be made payable to The Town of Cheverly.

Initial Here to Acknowledge: *

Reservation Details

Requested Venue: *

Gymnasium

Large Conference Room

Kitchen

Time (Start): *

Hour

Minute

Time (Finish): *

Hour

Minute

Begin Date: *

Month

Day

Year

End Date: *

Month

Day

Year

Is there a copy of your organizations liability insurance on file in the Town office? *

Yes

Initial Here to Acknowledge: *

PLEASE REMEMBER:

AS A CHEVERLY RESIDENT, THIS IS YOUR COMMUNITY CENTER. YOUR TAX DOLLARS BUILT IT AND MAINTAIN IT. PLEASE TAKE CARE OF IT AND LOOK AFTER IT AS YOU WOULD ANY OF YOUR OTHER VALUABLE POSSESIONS.
BE RESPONIBLE, BE A LEADER. IF YOU SEE SOMEONE ABYSING THE BUILDING OR GROUNDS, PLEASE NOTIFY STAFF
TALK TO YOUR ORGANIZATION, TEAM OR COMMITTEE. IMPRESS UPON THEM AS WELL THE NEED TO RESPECT AND LOOK AFTER THE BUILDING.
ENJOY THE COMMUNITY CENTER!

Please note you will need to come into the office to sign the document.

Date: ___________ Signature: __________________________________________________________

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