Stickney Recreation Center
4131 Home Avenue – Stickney, IL 60402
Rental Agreement
Name: _________________________ Phone: __________________ Cell: ____________________
Address: _____________________________ City, State, Zip: ______________________________
Date of Event: ________________________ Type of Event: _______________________________
Time of Event – From: ______ To:________ # of Guests (Max. 200): _________________________
Renter must show proof of residency with a photo ID.
Rental is available as early as 9:00 a.m. All events must end by 10:00 p.m.
For liquor use, a separate rider must be purchased by renter through your own insurance company, naming the
Village of Stickney as other insured.
Stickney
Non-Profit
Organizations &
Schools
Private Rentals
(Residents only)
First 2 hours
Each additional hours
Police/Security *
75-100 attendance
1 officer
101-200 attendance
2 officers
1-100 persons
101-160 persons
No Charge
No Charge
$100
$50
$130
$50
Kitchen
$35 flat rate
$25/hr. per officer
*Police Security will be required for any alcohol usage on the premises as directed by the Parks &
Recreation.
**Police security may also be required due to the nature of the rental.
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STICKNEY RECREATION FACILITY USAGE AND CONDITIONS
All Applicants must read and be familiar with the following policies:
1. The applicant, his/her organization, members, guests, and all users are bound by policy of
permit, its terms and conditions, regulations and ordinances pertaining to the use of Village
Recreation Property.
2. The applicant submitting request, listed as authorized representative, must be a minimum of 25
years of age.
3. All balances are due the Village five (5) business days before said usage date otherwise a $25
late fee will be added to the rental fee. This balance can be paid by cash, credit card, certified
check, cashier’s check or money order. NO PERSONAL CHECKS WILL BE ACCEPTED FOR THIS
PAYMENT.
4. Adequate adult supervision, as determined by the Village President or their designee must be
provided at all times. Usage groups may be required to employ Stickney Police Personnel when
deemed by the Village President or their designee due to the nature of the event.
5. ALCOHOLIC BEVERAGES ARE ONLY PERMITTED BY SPECIAL PERMIT OR BY AN APPROVED
LICENSEE OF THE VILLAGE, ON VILLAGE RECREATION PROPERTY.
6. The applicant, his/her organization, members, guests and all users agree to release the Village of
Stickney from all liabilities of use caused by said use of the Recreation Center.
7. Certificates of Insurance may be required from groups or organizations using Village facilities.
Certificates of Insurance should read as follows: The Village of Stickney, its elected and
appointed officials, all employees, and agents as additional insured.
8. A separate insurance rider is to be purchased through renter’s own home owner’s insurance
company and should read as follows: The Village of Stickney, its elected and appointed officials,
all employees and agents as additional insured. This special rider is due when you pay your
balance.
9. The Village of Stickney cannot and will not assume any responsibility for lost or damaged
property.
10. Permits for usage groups in excess of posted number of participants shall be only issued with
the specific approval of the Village President or their designee.
11. Use of sound amplification equipment is prohibited, except when specifically authorized on the
permit or in accordance to any applicable state or federal laws.
12. When publicizing meetings or events, the location shall read the location not the Village of
Stickney. Groups shall be required to advertise that the event is not sponsored or promoted by
the Village of Stickney.
13. Rental is available as early as 9:00 a.m. All events end by 10:00 p.m.
14. All usage groups will be responsible for rented area at the end of the usage period.
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Room(s) rented or used shall be left in the same condition as they were prior to the group or
individual, renting or using the room(s). This includes restrooms.
Groups or individuals renting or using room(s) shall be responsible for cleaning any area
within the room(s).
All garbage shall be placed in garbage receptacles or garbage bags provided by the Village.
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15. All usage groups will post a $100 security deposit to cover cost of any damage resulting from
usage at the time of booking. The Village reserves the right to seek any legal remedies in the
event that damages are greater than the deposit. All security deposits to be returned, shall be in
accordance to the Village refund policy. Any group found to have alcohol without special permit
on Village property shall forfeit the $100 security deposit. Unexpected or excessive damage or
spills will be subject to loss of deposit. Additional charges to the usage group in excess of the
security deposit are based on severity of damage. Severity of damage will be determined by the
village. The signatory to this Agreement may be held personally responsible for any damage cost
in excess of the security deposit.
16. Any group or individual serving food must comply with established Stickney Public Health
District regulations and procedures.
17. In accordance with Federal and State statues, all Village of Stickney facilities are designated
“smoke free” environments.
18. The Village of Stickney reserves the right to waive or reduce any and all fees associated with the
usage of any Village facility.
19. Any and all checks returned for non-sufficient funds will result in a minimum $25 service charge.
20. Use of piñatas must be kept outdoors from any Village facility.
21. Rental times reflect use of the room. Fifteen minutes set-up time will be provided, but take
down and clean up must be built into the rental time. Failure to follow this rule will result in
charges for time used taken out of the $100 security deposit.
22. The village will set up the room based on the applicant’s choice of pre- approved layouts. All
layouts are in accordance with state and local fire codes.
23. Limited parking is available behind the Recreation Center, otherwise street parking is allowed.
24. Police and Fire Department must have access at all times to the facility.
25. No ball playing of any kind is permitted in the building.
26. No religious services are to be held in the facility.
27. Smoking is prohibited in the building. Smoking will be allowed outside the building, but must be
within fifteen (15) feet from any entrance.
28. User shall comply with all laws, ordinances and rules of the Recreation Center, the Village of
Stickney, the State of Illinois and the United States, that are applicable to the use of the
facilities.
CANCELLATION CLAUSE:
The remaining balance is due five (5) working days prior to the date requested on the rental permit
application. The Village of Stickney retains the right to cancel the date if balance is not paid by the
deadline. Failure to comply will result in the forfeiture of the deposit fee.
If a notice of cancelation is received 30 days prior to event, a full refund of the Center rental fee will be
issued. If notice of cancelation is received between 15 to 29 days prior to the event, 50% of the Center
rental fee will be issued. If a notice of cancelation is received less than 15 days prior to the event, or no
one shows up for the event, NO Center rental fee will be refunded. In any event of cancelation, the
security deposit will be refunded in full.
The Village of Stickney reserves the right to cancel or change the permit within 48 hours when deemed
necessary by the Village.
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FACILITY USAGE AGREEMENT
We/I__________________________________(name of organization or group requesting usage) Agree
to release and hold harmless and defend the Village of Stickney, officials, employees, and agents, in
connection with any and all actions or claims for any loss damage, personal injury or death occurring as
a consequence of the performance of this agreement. It is further understood and agreed that the
Village of Stickney assumes no obligations or responsibility in connection with said use of facility.
We further agree to assume all cost of damage to facility and its contents during the usage period
authorized.
We/I affirm that I have read and understood the Facility Usage and Conditions of the Village of Stickney
and will adhere to them during the duration of said rental period.
We/I further understand that violation of the Village of Stickney Rules and Ordinances shall result in the
forfeiture of any deposit fees. Additional penalties and fines may occur for alcohol or other items
brought into any Village facilities.
I have agreed that there will be no liquor served at this function. If any liquor is found on the
premises, I understand that I am liable for prosecution under penalty of law. (if applicable)
We/I ACKNOWLEDGE RECEIPT OF, AND AGREE WITH AND CONSENT TO THE RENTAL AGREEMENT
WAIVER AND RELEASE OF ALL CLAIMS ATTACHED HERETO AND INCORPORATED HEREIN, PERTAINING
TO LIQUOR USAGE ONLY AS IS IN EXHIBIT “A”.
I have read, understand, and agree to all of the conditions stated in this agreement.
__________________________________________
(Signature of Responsible Party for renter)
___________________
(Date)
FOR OFFICE USE ONLY:
Date: _______ Name: ____________________________________ Rental Date: _______________
Special Requests: _________________________________________
# of persons _______
# of tables ___________
Liquor Served:
Yes
No
Use of kitchen
Yes
No
Approved: ________
Rental Total $ ________ Security deposit $__________ Balance due:__________ Date due: _________
Refund: Pickup $ ________ Mailed $____________
Total Received by: ____________
Copy of photo ID must be attached.
Copy of insurance policy for rider must be attached.
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Facility Deposit Return Request
All usage groups will post a $100.00 security deposit to cover cost of any damage resulting from said
usage. Fees are determined by the attached schedule. The Village reserves the right to seek legal
remedies in the event that damages are greater than the deposit. All security deposits to be returned,
shall be in accordance to the Village return policy. Any groups found to have alcohol not from an
approved vendor or by special permit on Village facilities shall forfeit the $100 deposit.
Renter’s Name:_________________________________ Rental Date:_________ Time: _________
Renter’s Address:________________________________ phone #: _______________
Kitchen use:
yes
no
# of guests: ____________ # of tables requested: _________________________
Condition of Room
(circle one) excellent
good
fair
poor (if fair/poor, give reasons and deductions below)
(If room condition is rated poor, you will be refunded only a portion of your security deposit, that amount will be
determined based on the reason for the rating.)
_____________________________________________________________________________________
_____________________________________________________________________________________
Please rate: yes or no
____Room(s) rented or used shall be left in the same condition as they were prior to the group or
individual, renting or using the room(s). This includes restrooms.
____Groups or individuals renting or using room(s) shall be responsible for cleaning any area
within the room(s).
____All garbage shall be placed in garbage receptacles or garbage bags provided by the Village.
____please refund $100 security deposit
____only _______ of the security will be refunded due to: _____________________________________
_____________________________________________________________________________________
____no security deposit refund due to: ____________________________________________________
_____________________________________________________________________________________
Signature of building maintenance personnel: _______________________________________________
Signature of renter: __________________________________________
(This form is to be filled out by maintenance personnel)
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Exhibit “A”
Village of Stickney
Recreation Center
4131 Home Avenue – Stickney, IL 60402
This WAIVER AND RELEASE OF ALL CLAIMS (this “Release”) is made by and between the Village of
Stickney, an Illinois Municipal Corporation, (the “Village”) and Renter (“Renter”) (collectively, the Village
and Renter may, for convenience only, be hereinafter referred to as the “Parties” and each individually
as a “Party”).
WHEREAS, Renter desires to and is renting the Village of Stickney, Recreation Center (“Center”) as
described hereinabove for an event (“Event”) as described hereinabove; the Village owns the Center;
the Parties have determined that it is in the best interest of the Parties to enter into this Release.
THEREFORE, FOR AND IN CONSIDERATION of Renter being allowed to use the Center for the Event and
Renter paying certain consideration as above-described, Renter hereby releases, waives, discharges and
covenants not to sue the Village, its past and present officials (whether elected or appointed), trustees,
directors, employees, agents, officers, servants, representatives, attorneys, Independent contractors,
Insurers, volunteers, successors or predecessors and any other party in any way related to the Village
(collectively, the “Released Parties”) of, from and for any all claims, losses, demands liabilities, penalties,
liens, encumbrances, obligations, causes of action, costs and expenses, (including reasonable attorneys’
fees and court costs) and damages (whether actual or punitive) that occurred or are alleged to have
occurred in whole or in part in connection with Renter’s use of the Center, the Event, this Release and
the intentional or unintentional acts or omissions of the Released Parties stemming from Renter’s use of
the Center or the Event.
Renter intends to use the Center for the Event and fully and willfully assumes full responsibility, during
and after the Event, for Renter’s decision to use, at its own risk, the Center and for what instructions or
information to receive or follow. Renter understands that holding the Event, which Renter is choosing to
do, bring with it the assumption of all risks and liability for the event. Renter agrees that it will not allow
individuals to participate in the Event if said individuals are in unfit physical conditions or are not
physically able to participate in the Event.
To the fullest extent permitted by law, Renter shall indemnify, hold harmless, and defend the Released
Parties of, costs and expenses (including reasonable attorney’s fees and court costs) and damages
(whether actual or punitive), whether known or unknown, suspected or unsuspected, contingent or
actual, liquidated or un liquidated, that occurred or are alleged to unintentional acts or omissions of the
Intentional or unintentional acts or omissions of the Released Parties stemming from Renter’s use of the
Center or the Event.
During the term of this Release, Renter, at its sole cost and expense and for the mutual benefit of the
Parties, IF SO REQUIRED BY THE VILLAGE (VILLAGE TO CHECK BELOW AS APPLICABLE), shall carry and
maintain the following types of Insurance with companies and in forms reasonably satisfactory to the
Village as required by the Village.
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Village
Renter Agrees
(initial here)
Comprehensive general liability and property liability insurance, including legal liability,
insuring against all liability of Renter arising out of or occurring in connection with
Renter’s use of the Center and/or Event, with a minimum combined single limit of one
million (1,000,000). Such policies shall name the Village and its President as Additional
Insureds and provide that it is primary to, and not contributing with, any policy carried by
the Village of Stickney covering the same loss; and
Excess liability for ____1,000,000.00____
(ENTER AMOUNT) per occurrence
_________
_________
Renter shall provide the Village with certificates of Insurance acceptable to the Village evidencing the
existence of the coverage described above. The failure to provide acceptable certificates of insurance
shall be deemed a breach of this Release endorsement that no coverage may be canceled, terminated or
reduced by the insuring company without the Insuring Company having first given at least thirty (30)
calendar days of written notice to the Village. Renter shall deposit with the Village all such policies or
certified copies if requested.
Renter further acknowledges that an authorized representative of Renter: (a) reads and understands
English and has carefully read the contents of this Release; (b) is competent, of lawful age and has legal
authority to enter into this Release; (c) has not been given any promise or inducement to sign this
Release (d) understands that this Release is intended as a complete waiver and release in favor of the
Released Parties; (e) assumes full responsibility for any damage or loss that occurs or is alleged to have
occurred as a result of Renter’s use of the Center, the Event or any violation of this Release; and has
signed this Release as Renter’s free and voluntary act. RENTER HAS READ THE FOREGOING RELEASE IN
ITS ENTIRETY AND FULLY UNDERSTANDS EACH AND EVERY PROVISION CONTAINED HEREIN.
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