Property Use Request Form .pdf
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Title: Property Use Request Form.docx
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Property Use Request Form
Name of Organization/Individual:
Responsible Person who will be present at the event:
Space(s) to be utilized:
Recital Hall or Recital Hall and Lobby
(30 minutes will be added to start and end time to accommodate set up and clean up)
Expected Number of Participants:
Will there be food/drink?
Special Needs or Requests:
__ Tables (how many?)
__ Chairs (how many?)
Organizations are required to provide certificates of insurance naming Potter Violins as
additional insured. If no insurance is available, additional fees will be incurred. Certificates
must be resubmitted annually. Do you have a certificate of insurance?
Contract is not final until a 50% deposit, $100 cleaning deposit, certificate of insurance and the
Release and Indemnity form have been received. Please do not send anything until you have
been notified that this request has been approved.
Potter Violins: Received on
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