Cortlandt Community Volunteer Ambulance Corps

PO Box 275, Montrose, NY 10548

Request for use of Cortlandt Ambulance Corps’ Second Floor Hall

This form must be filled at least two weeks before event. Emergencies will be handled on an as need basis.

Only members may request use of the space.

Date of Application _______________________________________________________

Submitted by ____________________________________________________________

Day and Date of use ______________________________________________________

Type of event ___________________________________________________________

Time event STARTS ______________________ENDS _________________________

Additional time needed to set up/clean up ____________________________________

Corps functions will be given priority over individual member events. Because of on going classes some Saturdays (day time hours) may become unavailable at short notice. Every accommodation will be made to not impose last minute changes on member’s use of the space. A signed agreement must be on-file in advance for all but the most immediate emergencies. President’s decision is final and binding.

I have read and understand all the rules of space usage.

Signature of applicant ________________________________________ date _________________

Signature of president ________________________________________ date _________________

Approved_______    Denied ________________________________________________________

CORTLANDT COMMUNITY VOLUNTEER AMBULANCE CORPS

AGREEMENT FOR USE OF SECOND FLOOR SPACE

1.       Cortlandt Community VAC is a smoke free facility. Smoking is not permitted inside the building.

2.       Children must be under the control of adults at all times.

3.       You will have the use of the second floor facilities only - guests (NON-CCVAC MEMBERS) are not allowed in the ready room or ambulance bays.

4.       You will have the use of the kitchen to store, heat and assemble food. No cooking, broiling, or baking allowed.

5.       There is to be no alcoholic beverages on the premises.

6.       Since the facility is located close to a residential area, we ask that you please exit the premises quietly when the function is concluded.

7.       No one is to park in the member’s only parking area.

8.       Food, beverages, etc. must be removed from premises at conclusion of party.

9.       It is expected the kitchen will be left in the same condition as it was found.

10.       Any tables and chairs rearranged must be placed in their original position.

11.       A CCVAC member must be present for the entire function.

12.       Maximum capacity is 102 persons.

13.       Member sponsoring event is responsible for any damage to the premises as well as to the carpeting including stains.

14.       It is expected that the area will be clean of all waste at the conclusion of the party.

15.       Violation of any of the above will result is member being denied use of the premises in the future.