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ANAHEIM COMMUNITY SERVICES DEPARTMENT APPLICATION FOR MULTIPLE DATE USE OF THE EAST ANAHEIM COMMUNITY CENTER 8201 E. Santa Ana Canyon Road, Anaheim, CA 92808 Phone 1.[PHONE REDACTED] Fax 1.[PHONE REDACTED] Rental # Entered by: Date: □ Approved Authorized □ Denied Room(s) Requested: Desired Date Month: Day: Year: Hours: am/pm to am/pm Type of Event: Estimated Attendance: Will alcohol be served? □ Yes □ No Will food be served? □ Yes □ No Will event be professionally catered? □ Yes □ No Name of catering company: Applicant Name: Organization Name: Type of Organization: Mailing Address: City: Zip Code: Phone: Email: EVENT SCHEDULE (INCLUDE ALL EVENT SET-UP/PREPARATION AND CLEAN UP TIME AS ROOMS WILL BE OPENED AND CLOSED BASED ON TIMES LISTED BELOW) January Dates: Time: am/pm to am/pm July Dates: Time: am/pm to am/pm February Dates: Time: am/pm to am/pm August Dates: Time: am/pm to am/pm March Dates: Time: am/pm to am/pm September Dates: Time: am/pm to am/pm April Dates: Time: am/pm to am/pm October Dates: Time: am/pm to am/pm May Dates: Time: am/pm to am/pm November Dates: Time: am/pm to am/pm June Dates: Time: am/pm to am/pm December Dates: Time: am/pm to am/pm ROOM SET-UP □ Chairs Only: Theatre style to accommodate □ Chairs & Tables: Banquet style to accommodate □ Chairs & Tables: Classroom style to accommodate □ Other (Please describe) EQUIPMENT REQUESTED (BASED UPON AVAILABILITY) □ Microphone (Wireless) □ Microphone Stand □ Bluetooth Speaker and Stand □ Projector and Projection Screen □ Podium □ Dry Erase Board □ Easel-Flip Chart Stand □ USA Flag □ California Flag □ Kitchen Access (Refrigerator/Freezer, Coffee Maker, Food Warmer, Micro- wave, Ice Machine) —HOLD HARMLESS INDEMNIFICATION— By executing the AGREEMENT, TENANT acknowledges that TENANT has received a copy of the “ACS FACILITY USE GENERAL REGULATIONS.” These Regulations are considered to be incorporated in the AGREEMENT. TENANT shall abide by all terms and conditions contained therein, and any modifications to such Regulations of which TENANT receives written notice. TENANT may obtain additional copies of the Regulations from an ACS representative. TENANT agrees to indemnify. Defend (at CITY’S option) and hold harmless the City of Anaheim (CITY), their officials, officers, and employees (also referred to as “INDEMNIFIED PARTIES”) from and against any and all claims, demands, defense costs, liability, expense, or damages of any kind or nature arising out of or in connection with TENANT’S use and/or occupancy of ACS premises or arising out of any act or omission of TENANT or any of TENANT’S employees, agents, contractors, representatives, patrons, guests, or invitees’ excepting such claims, demands, defense costs, liability, expense or damages arising out of the sole negligence of one or more of the INDEMNIFIED PARTIES. Notwithstanding the provisions of the above paragraph, TENANT further agrees to assume all risk, and to indemnify, defend, and hold harmless the INDEMNIFIED PARTIES from and against all claims, demands, defense costs, liability expense, or damages of any kind or nature arising out of or in connection with damage or loss of any property belonging to TENANT or TENANT’S employees, exhibitors, contractors, representatives, patrons, guests, or invitees. It is understood by the parties that, should TENANT wish to attempt to mitigate its liability for damage to or loss of the property of its exhibi- tors, it is the sole responsibility of the TENANT to ensure that TENANT’S agreements with its exhibitors contain wording holding TENANT and the INDEMNIFIED PARTIES harmless for such loss or damage; however the inclusion or exclusion of such language in no way diminishes TENANT’S liability or responsibility to the INDEMNIFIED PARTIES under this paragraph. TENANT further agrees to indemnify CITY for damage to or loss of CITY property arising out of or in connection with TENANT’S use and/or occupancy of an ACS premises, or arising out of any act or omission of TENANT or any of TENANT’S employees, agents, contractors, representatives, patrons, guests, or invitees; excepting such damage or loss arising out of the sole negligence of one or more of the INDEMNIFIED PARTIES. I have read and understand the above Regulations and Hold Harmless/Indemnification and agree that my group and I will abide by these. Tenant’s Name (printed) Tenant’s Signature Date: SIGN SIGN