THE MILLENNIUM GROUP
BUILDING USAGE AGREEMENT
This building Usage Agreement dated___________________ by and between the Millennium Group (MG) and
(User/Sponsor)
______________________________________________________________________________________________
MG is a non-profit organization
Address: P.O. Box 23 Lovingston, VA 22949
434-263-4659 or 434-263-4259
User/Sponsor Contact Information (Must be over 21)
Name:
__________________________________________________________________________________________
Address:
________________________________________________________________________________________
Phone: day)_____________________(Evening)__________________
Building or Premises to be Used
List site: Auditorium’_____ *Kitchen_____ Gym____ Home Economics Room______ Other____________________
Date:__________________________________________________________________________________________
Time From:______________________am/pm To:____________am/pm
Nature of Use:
______________________________________________________________________________________________
______________________________________________________________________________________________
Anticipated # of guests:____________________________
Age range of guest ______________________________
What outside equipment will be brought in?
______________________________________________________________________________________________
______________________________________________________________________________________________
Will tables and Chairs be needed? If so, how many:
Tables_____________________Chairs___________________________________
____User will set up and put away
____User will pay $50 to have them set up and put away
FEES: Deposit and rental fees are due at time of reservation. All checks should be made
payable to: The Millennium Group
Deposit: $50 - Returned within 7 working days if building left clean and undamaged.
Table and Chair Set Up: $50
Rental fees for community functions: $150 for first 4 hours, $25 per hour after 1st four hours.
Refunded if cancellation is made 3 weeks prior to event. . Staff $8/per hour, paid directly to staff person
*Additional fee for use of kitchen.
I have read, understand, and agree to abide by the RULES for USE of the building/premise.
Signature of User/Sponsor_____________________________________________ Date ____________________________ _______
Office Use Only
Approved ____________________________________Date:______________________________________________
Deposit Paid:$_____________Returned:______/______/_______Reason if not returned:_______________________
Rental Paid $_________Receipt #_______Rental Returned___/___/ Reason (if any)___________________________
Table & Chair set up Paid;$_______________________Staff assigned to set up:____________________
Supervisor Paid ________________________________:
_______________________________________________________________________________________
Revised July 2005