Community Family Enrichment Center

301 North 23rd Street — P.O. Box 582/ Arkadelphia, AR 71923/

(870) 246-5675/ FAX (870 246-5656

Building Usage Request Form

Application Date:
Section of Building to be Used: Approved
Date of the event: Denied
Time of Event: From To
Number of Guests: Adults Children

Director’s Signature, Date

As the responsible party for this event, I hereby agree to (a) reimburse the
Community Family Enrichment Center for any and all damages to the center’s
property that may occur in connection with my event/activity and (b) be responsible
for the orderly conduct of all persons when they are in the building or on the
premise during the time of the activity and (c) the use of alcohol and drugs are
strictly prohibited.
Name, address, phone # or organization

(Signature) Responsible Party and Date

Purpose of activity/event/meeting:

Please make a check or money order to the Community Family Enrichment Center.
The deposit/ set-up fee is not refundable. Any group renting the facility for social
functions may be required– at the Director’s discretion– to provide private security.

Rental Fee Schedule Capacity

Large Multipurpose Room 225 $300 (1-8 hours) $
Kitchen $50.00 (1-4 hours) $
Conference Room 20 $30.00 (1-4 hours) $
Classroom 25 $50.00 (1-4 hours) $
Small Multipurpose Room 35 $75.00 (1-8 hours) $
(Next to Kitchen)
Net Total: $
Add: $
Deposit/Set-Up/Clean Up Fees:
Large Room: $50
Small Room: $25
(Due two (2) weeks before the event) Gross Total: $
*Tables and chairs will be provided without any additional cost.

Rental Supplies and Equipment

The prices listed below are with the rental of the building only!
PA Systems
P.A. System # $10.00 $_____
Portable PA System w/ handheld
or clip microphone # $5.00 $_____
Electrical Cords # $1.00 $_____
Decorative Trees
Ficus Trees # $2.00 $_____
Tables/Chairs (when not using the building)
Tables # $10.00 $______
Chairs # $2.00 $______
If tables or chairs are damaged, the cost to replace the tables and chairs will be the
responsibility of the person renting the items or in charge of the activity.
 Building and Usage Questionnaire/Requirements/Agreement
This building is not reserved until the deposit/Setup fee is paid. The total amount for
building usage must be paid two weeks in advance. The reservation will be canceled if
the total payment is not received two weeks in advance. Usage of other rooms and
equipment must be approved prior to the event.
Large Room Rental: $300 Small Room Rental: $75
Set-up Clean up: $50 Set-up Clean up: $25
(No Exceptions) (No Exceptions)

Total: $350 Total: $100

Reservation for the facility is for a total of 8 hours which includes set-up and take-down
time. Any additional time that is requested beyond 8 hours will cost $50 per hour.
1. Children are not allowed in the playground area located in the back of the
Community Family Enrichment Center. Children must be supervised at all times
by an adult inside and outside the building.
2. Any damages to the building and/or equipment are the responsibility of the
responsible party.
3. On the day of your event/activity, what time will you need the building opened?
4. What type of tables do you need for the event? (Depends on the seating
arrangement) Round: 6 or 8 seating per table.
Round _____ Oblong _____ Combination _____.
5. You are responsible for the removal of all items from the building. This includes
food, flowers, streamers, etc.
By signing as the responsible party, you agree to the terms of this agreement and to
pay for any damages to the building and/or content during your scheduled event.

Print Name (Responsible Party) Signature (Responsible Party)