EDMUND KEEFE AUDITORIUM

RENTAL APPLICATION & AGREEMENT

(8/4/03)

(Renters must fill out all the information on this page and sign the form on page 2.)

Date of Application: __________ Organization:______________________________________

Profit___ Non-Profit___ Date(s) Facility Requested:___________________________

Type of Function: _________________ Number of Spectators Anticipated: ______________

Rehearsal Date(s): __________________ Rehearsal Times: ______________ to _____________

Performance Date(s): ________________ Performance Times: _____________to____________

Facilities Requested For Rehearsals:

Auditorium ____ Stage ____ Other: _________________

Facilities Requested For Performances:

Auditorium ____ Stage ____ Other: _________________

Will food be served? Yes ____ No ____ Will beverages be served? Yes____ No____

Equipment: (Note: Use of stage rigging, lighting and sound systems requires the presence of an individual authorized by the Nashua School District. Contact the Plant Operations Office for a current listing.)

Will you be utilizing the stage rigging? Yes _____ No _____

If yes, name of authorized individual: ______________________________

Will you be utilizing the stage lighting? Yes _____ No _____

If yes, name of authorized individual: ______________________________

Other equipment requested (include number): Folding Tables ____ Folding Chairs ____

FACILITY RENTAL REQUIREMENTS:

1. Provide an active liability insurance certificate in the amount of $1 million per occurrence ($2 million aggregate) naming the “City of Nashua as Additionally Insured”.

2. Provide Damage/Security Deposit of $500 (check made payable to the Nashua School District). This deposit will be used to defray the cost to repair damage caused by the renting organization (beyond normal wear and tear) and/or cleaning of the Auditorium and adjoining spaces. The check will be returned to the renter if no damage occurs and/or extra cleaning isn’t required. Renting organizations are expected to leave the Auditorium in a clean and functional condition.

3. Fees. The auditorium is rented at rates established by the Superintendent of Schools. In addition to this fee, the renting organization must pay for at least one custodian to be present when using the facility, for safety and security. (The number of custodians required will depend on expected crowd size.)

4. Rental Checklist. Before the first use of the facility, the organization’s contact person must accompany a member of the plant operations office to check the conditions therein.

Acknowledgement of Conditions and Signature:

I have read the regulations concerning use of the Edmund Keefe Auditorium at Elm St. Junior High School and agree to comply with the conditions listed.

Name (please print): ______________________________ Phone:_________________________

Signature: ___________________________________ Date: _________________________

Contract Approval:

The following have been received or completed:

1. _____ Liability Insurance Certificate in the amount of $1 million.

2. _____ Security Deposit for $500 made payable to the Nashua School District.

3. _____ Rental Checklist.

4. _____ Waiver of Liability

5. _____ Applicable Permits (Fire, Health, Police)

The following are the estimated fees the requesting organization will incur:

1. Rental:

a. Rehearsals. Number of Days ______ $_________

b. Performances. Number of Days ______ $_________

2. Custodial. Number of Hours ______ $_________

3. Piano $_________

4. Other: _________________ $_________

Total: $_________

All conditions for the rental of the Edmund Keefe Auditorium have been met. The application is hereby approved.

Signature of Plant Operations Official: _________________________ Date: _______________

AUDITORIUM RENTAL CHECKLIST

The following items must be inspected by the renting organization and a plant operations employee prior to the rental dates, and upon the renting organization’s departure.

EXCEPTIONS

1. Curtains must be hung on the specified battens:

Batten #22 – Grey Cyclorama ________________________________

Batten #18 – Black Legs ________________________________

Batten #16 – Black Border ________________________________

Batten #13 – Black Traveler ________________________________

Batten #10 – Black Legs ________________________________

Batten #8 – Black Border ________________________________

Batten #5 – Black Traveler ________________________________

Batten #3 – Red Legs ________________________________

Batten #1 – Red Border ________________________________

Batten #0 – Red House Curtain ________________________________

2. Electric Battens 2, 9, and 17 are in working order ________________________________

3. Symphony shells (if used) go on battens 4, 11, 14, 21) ________________________________

4. All Battens are in working order (note exceptions) ________________________________

5. All Battens are properly counter-balanced ________________________________

6. Stage weights are neatly stacked behind the ropes ________________________________

7. Lighting board and dimmers are operational ________________________________

(note any exceptions)

8. The footlights are in a closed position ________________________________

9. The grand piano is in the storage box ________________________________

10. The large black masking flats are stored at stage left ________________________________

11. Stage, auditorium, main entry, bathrooms, hallways, ________________________________

classrooms and stairways are free from trash/debris

12. Renting organization trash/debris is placed in ________________________________

container provided behind stage.

Pre-Inspection Date: ___________ Renter:____________________ NSD:_________________

Post-Inspection Date: ___________ Renter:____________________ NSD:_________________