NHIC Premises Usage Agreement

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NHIC Premises Usage Agreement

Facilities Use Policy and Registration Form

First Name: *

Last Name: *

Organization Name:

Title

Cell Phone #: *

Email: *

Street Address: *

City: *

State: *

Zip: *

Usage Purpose *

Start Date

YYYY

Start Time *

Time

End Date *

YYYY

End Time *

Time

Number of Guests/Participants

Please Read Carefully

APPROVAL / PERMISSION POLICY

NHIC reserves the right to grant, deny or cancel permission for facilities use request.

AUTHORIZATION / RELEASE

o On behalf of all guests/participants, I hereby release, discharge, and agree to hold harmless New Haven Islamic Center and its officers, volunteers, administrators, and other representative from any and all claims, demands, cost, expenses, and compensation arising out of or in any way related to any injury or other damage that may result while on premises.

o Furthermore, I assume all risks incidental to the use of said facilities and shall be solely responsible for any and all accidents and injuries to persons (including death) and/or property damage arising out of or in connection with its activities and use of facilities.

o I agree to indemnify, defend, and hold NHIC harmless if a claim is brought against NHIC arising out of the group’s use of the NHIC property.

I, ACKNOWLEDGE AND AGREE TO ABIDE BY THE FOLLOWING:

o It is my responsibility to take proper measures to prevent any untoward incidence, ensuring the safety of participants/guests.

o If approved, authorization will be for a nonexclusive use of facilities. No activity will be conducted which interferes with the normal operation of the Masjid including prayers, classes, and regularly conducted events.

o All activities conducted will be in accordance with basic Islamic principles and in observance of local, states and federal rules, regulations, and laws of the United States of America.

o All attendees must behave in a dignified and respectful manner inside the premises, observing all manners of generally accepted masjid etiquette. All attendees will dress in a manner that is dignified and respectful of the house of Allah (SWT).

o All activities involve children/minors must have adequate number of parents/adults for supervision.

o I also attest and acknowledge that the number of attendees will not-at any time-exceed 270 people as the occupancy licensed by fire marshal for this unit.

o No pork or alcohol is allowed to be served or consumed in the premises, and no loud music.

o Upon completion of the event, the facility and all property must be returned to the same state of maintenance and cleanliness as before.

STEP 4: Sign & Submit Your Form

By signing this application, I agree to abide by the NHIC By-laws otherwise my membership may be revoked. I confirm that the information I have provided is correct. I accept that any false information that I have provided will invalidate this application.

I understand that I have to email a copy of my driver's license or bring a printed copy; otherwise, this application will not be processed. *

I will email a picture to info@nhicct.org

I will physically bring a copy of my ID or will present one to be photocopied

I will mail a copy to the Masjid's address

I understand that by typing my full name below, I am officially signing this application. *

Date: *

YYYY

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