Austin Lodge Agreement for Use: 
Thank you for deciding to host your upcoming retreat at our Austin Lodge located at 109 Rinard Lane in Rochester PA. Please complete the form in a timely manner so as to not interrupt your first day of accommodations. We look forward to hosting you and hope you have a wonderful time staying with us.  

Contact Becky Hetzer with any questions or concerns 

rjhetzer@gmail.com or at (724)822-7862. 

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Retreat Group Name/Entity  *
Check in Date  *
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Check out Date  *
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Retreat Leader Name:  *
Retreat Leader Phone Number:  *
Retreat Leader Address:  *
Retreat Leader Email Address:  *
Number of Guests Staying at the Lodge:  *
Age Range of Guests:  *
Retreat Guest List: 
Please list the first and last names of ALL individuals staying the Austin Lodge for your retreat: 
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Austin Lodge 
The Austin Lodge is a great place to stay for a Retreat: 
Capacity is 25 people 
          $40 per night per person 
Austin Lodge Payment 

You can pay online with your Credit or Debit Card

or you can mail a check: c/o Becky Hetzer

Made Payable to Hosanna Industries 
PO BOX 719 Gibsonia PA 15044 
Statement of Understanding
Hosanna Industries actively reserves the right to dismiss any individual or group which it finds to be in opposition to our mission’s values and principles. Rough behavior, aggression and or violence, lack of cooperation and or suitable diligence, insufficient respect and regard for Hosanna’s leadership and long-term investment in the charitable field of our calling and or a poor relational disposition are unacceptable to Hosanna Industries and will unfortunately result in immediate dismissal.
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Required
Hosanna Retreat Agreement 
WHEREAS, the Organization has requested permission from Hosanna Industries, Inc. (“Hosanna”) to use their facilities as set forth in separate documents; WHEREAS, as a condition of the use of the facilities, the Organization has agreed to release and indemnify Hosanna Industries regarding any liability which results from the Organization’s use of the facilities. NOW, THEREFORE, intending to be legally bound hereby and in consideration of permission to use the facilities of Hosanna, the Organization does hereby agree as follows: 1. The Organization completely and fully releases Hosanna from any and all claims, action, liabilities or demands against Hosanna that arise out of or any way relate to the Organization, its properties, volunteers, guests, employees, agents or any other affiliated parties in using the facilities of Hosanna. 2. The Organization shall defend, indemnify and save and hold harmless Hosanna from and against all loss, damages, suits, liability, claims, demands or cost resulting from any injury, harm or damages to persons or property in connection with the use by the Organization of Hosanna’s facilities, including any injury, damages or harm proximately caused by any act or omission of the Organization in connection with the use of the facilities. The Organization shall assume full responsibility for, and handling of, any such damage, suit, liability claim, injury or demand arising out of any such indemnified acts or omissions of the Organization in connection with the use of the facilities, including payment of all expenses, counsel fees, judgments and/or settlements incurred in connection therewith, provided that Hosanna shall have the right to reasonably approve legal counsel employed to defend it in any such action and to reasonably approve any proposed settlements. 3. The Organization agrees to properly supervise, control and monitor any and all individuals using Hosanna facilities and shall abide by all rules, regulations and policies of Hosanna, and shall further require all individuals using said facilities to do so in a safe, reasonable manner.
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Required
Austin Lodge Agreement for Retreat Leader: 
(by checking this box you have given a "virtual signature" to confirm your upcoming stay at the Austin Lodge for the agreed upon dates. You also confirm all data provided in this form is accurate. If any changes need made you will contact Becky Hetzer at rjhetzer@gmail.com to confirm updates as soon as possible) 
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Required
Hosanna Agreement: 
(leave blank-this will be signed in person upon check in as final confirmation of agreement of terms ) 
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