Fillable Application-for-Public-Use-of-County-Hampstead-Annex Pender County Courthouse Square

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Application-for-Public-Use-of-County-Hampstead-Annex Pender County Courthouse Square

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BROWSE PENDER COUNTY GOVERNMENT (NC) FORMS

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Pender County
Application for Public Use of County Facilities
~ Hampstead Annex ~
Organization’s Name:
Contact Name: _______________________________________Title:
Mailing Address:
Phone Number(s):
Meeting Room Being Requested:
Date and Time of Use:
Purpose of Use:
Number of persons using room (approx.):
Any Additional Information:
The Pender County Hampstead Annex has three rooms available for use by Pender County residents
affiliated with bona fide groups, educational, cultural, civic, governmental, non-profit, and other
community groups for public meetings when they are not in use for County government functions.
Businesses located in the county may use these facilities only for educational in-house programs for
their employees. Official County activities or functions will always have priority over other activities or
functions and the County reserves the right to cancel any room reservation(s) at any time due to a
County activity or function.
AVAILABILITY
Room reservations may be made to use the available rooms between 8:00 a.m. and 8:00 p.m.
Monday through Friday. Due to limited staffing and associated operational costs, rooms are
generally not available for use on weekends or Pender County Holidays. Requests for room
reservations must be made at least ten (10) days in advance of the meeting/event.
Available Rooms
1) Conference Room # 102 (1
st
Floor) – Includes conference table with seating for 12, TV/Monitor,
and Whiteboard
2) Conference Room # 214 (2
nd
Floor) – Larger Conference room. Includes conference table with
seating for 12 plus eight (8) additional guest chairs, TV/Monitor/Whiteboard, and serving
credenza.
3) Auditorium: 244 Fixed auditorium seats, Podium with self-contained audio system. No other
audio, video, or projection equipment is available and users are advised to bring their own
audio/visual equipment.
** Pender County does not provide folding chairs or tables for use in the Auditorium.
Page 1 of 4
Rooms are available for use by Pender County residents affiliated with bona fide groups,
educational, cultural, civic, governmental, non-profit, and other community groups for public
meetings when they are not in use for County government functions at no cost.
Any out of county resident, user, or group will be required to pay the following Rental Fee at least
10 days prior to the use of the facility. Only Checks and Money Orders will be accepted. No cash
is accepted. Please make checks and money orders payable to “Pender County”.
OUT-OF-COUNTY RENTAL FEES
Conference Rooms # 102 and # 214 - $ 25.00 per hour
Auditorium - $ 100.00 per hour or $ 400.00 per day
TERMS AND GUIDELINES FOR USE
Use of the facilities in no way constitutes an endorsement by Pender County of any group’s
activities or beliefs. The county shall not discriminate in providing meeting room space on the basis of
race, religion, age, gender, political affiliation, national origin, or disability.
1. The use of the county’s meeting rooms will be limited to meetings for which no admission
charge, fee, dues, or donations may be charged or solicited by the user, nor may any item or
service be sold or advertised. Also prohibited is use by a business or commercial use for
purposes of sales or negotiating for and/or completion of such sales. Registration fees for
programs sponsored by a county department, agency, or a non-profit educational group for
classes, workshops, discussion groups, or forums is acceptable.
2. Reservations shall be on a first-come first served basis. Reservations should be made by a
person 21 years or older at least ten (10) days in advance and standing reservations (i.e. “second
Tuesday of each month) are generally prohibited. Only approved government affiliates may be
allowed standing reservations under certain conditions.
3. All rooms are to be accessed through the main entranceway to the building (frontage facing US
Highway 17). The Annex and all rooms are ADA accessible.
4. There are only 120 paved parking spaces at the facility. Overflow parking is available at the
adjacent ballfield.
5. Requests for use of any available room in the Hampstead Annex shall be submitted on this
application form to Lidka Sullivan (Annex Receptionist) at lsullivan@pendercountync.gov or by
calling 910-270-6704. Application forms are also available at the Hampstead Annex and on the
County’s web site. All applications are subject to review and approval by the County Manager
and the Board of Commissioners.
6. The person/organization booking the meeting room shall be responsible for arranging the room
or facilities ahead of time to suit their needs and for returning the room or facilities to orderly
condition. County staff does not set up chairs or tables. Organizations may be placed on
probation or prohibited from future use of the facilities if the responsible representative fails to
carry out the duties outlined herein satisfactorily.
7. There are no on-site kitchen facilities for public use and food may not be prepared on the
premises. Food and beverages (cups with lids or bottles are encouraged) may be brought into the
building, but are only allowed in the two (2) Conference Rooms.
Page 2 of 4
No food or beverages are allowed in the Auditorium at any time. No smoking,
firearms/weapons, gambling, or alcoholic beverages are allowed inside any County
buildings.
8. When a meeting is scheduled after County hours, appropriate arrangements must be made to
properly secure and vacate the building as scheduled. Each user is responsible for leaving the
room(s) in a clean and orderly manner and turning off the lights. All materials shall be collected
from the garbage can(s) in the room(s) and placed in the dumpster outside the building when
exiting the building.
9. In any advertisements for meetings, the County’s name may be used only in conjunction with the
specific location of the meeting.
10. No room may be considered reserved until the written application has been approved via
hardcopy or email.
11. The Pender County Board of Commissioners reserves the right to deny the use of the facility to
any person or organization at any time and is the final authority on the interpretation and
modification of the Policy for Public Use of Pender County facilities.
ADDITIONAL TERMS FOR AUDITORIUM USE
1) Food and/or drinks are prohibited in the Auditorium and backstage dressing areas.
2) Nothing may be pinned, stapled, sewn, taped or attached in any manner to the stage curtains.
3) Only soft dance shoes and non-mark soled shoes are allowed on the stage floor. There are to be
no spiked/stiletto heeled, tap, or clogging shoes on the stage.
4) The Auditorium has 244 fixed seats available. No chairs, tables or other fixtures may be placed
in the aisles at any time. “Standing Room” and sitting is also prohibited in the aisles. At no time
may the total room occupancy, including those sitting or standing on the stage or dressing room
areas exceed 300.
RELEASE FROM LIABILITY
The undersigned hereby releases Pender County, its Commissioners, agents or employees, or any
other person, firm, corporation or other entity from any and all claims, demands, damages, actions
and causes of action, suits, losses and liabilities, however denominated, whether known or unknown,
contingent or absolute, apparent or unapparent, accrued or unaccrued, arising out of or related in any
way to:
(a) the undersigned’s use of, presence at, ingress to or egress from said County Facilities;
(b) any act, omission, event, incident, transaction or occurrence of any person, firm, corporation or other
entity on or in the vicinity of said County Facilities; and
(c) any circumstance or condition (latent, obvious or otherwise) in or near the vicinity of said County
Facilities.
It is also understood the undersigned is responsible for any damages that may occur to the County
Facilities during the time of usage and further agrees to reimburse the County for the cost of repair.
Page 3 of 4
The undersigned has had a full and fair opportunity to read, consider the same and obtain legal or other
advice; and the undersigned represents to Pender County, and acknowledges that such representation is
material and may reasonable be relied upon by Pender County, that the undersigned has read,
understands, and fully consents and agrees to the foregoing.
Applicant Signature___________________________________________ Date:
For Office Use:
Fees and Charges: $ per (hour or day)
Approved ______ Not Approved ______
Special Conditions:
County Staff’s Signature____________________________________Date:_________________
Please return completed form and Rental Payment to:
Pender County Hampstead Annex Receptionist – Room 101
15060 US Highway 17 N.
Hampstead, NC 28443
Phone 910.270.6704
Page 4 of 4
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Completed 1 November 2019

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