Atascadero Association of Retired People
7484 Pismo Avenue
Atascadero, California 93422
Approximate Times :_________________________
Name/Organization_____________________________________________
Address______________________________________________________
Telephone Number(s)___________________________________________
City, State, ZIP________________________________________________
California Driver's License_______________________________________
Place of Employment___________________________________________
Telephone Number_____________________________________________
RENTAL FEE____________ CLEANING/SECURITY DEPOSIT____________
(Refundable)
[Office Use Only_____________________________Received Date__________________]
Security Guard(s) @________for 4 hours coverage
(necessary if Hard Alcohol Present)
Signature________________________________Date_______________
[ MY SIGNATURE ALSO CERTIFIES I HAVE READ & UNDERSTAND CLUBHOUSE USAGE INSTRUCTIONS AND AGREE TO PAY FOR ALL OR ANY DAMAGES TO BUILDING OR PROPERTY INCURRED DURING USAGE]
Rental fee and security deposit must be received and dated no later than thirty (30) days prior to the date(s) of reservation. PLEASE make check(s) payable to Atascadero Association of Retired People. If you have any questions, please call the number above or __________. After completing this form, return to Post Office Box 111, Atascadero, Ca 93423 with appropriate checks/money orders.
THANK YOU