Application for Use of Stone Academy The authority to allow non-affiliated groups to use the Stone Academy rests solely with the Board of Trustees of the Pioneer and Historical Society of Muskingum County. The following guidelines and procedures should be followed when requesting such use. 1. A written application is required. Applications must be submitted to the Director at least 45 days prior to the event. 2. The applicant must assume full responsibility for any damage to the facilities that may occur during use. 3. Light refreshments are permitted. 4. Smoking is not permitted in the building, or on the grounds of the Stone Academy. 5. The maximum capacity is 45; 35 when refreshments are provided. 6. Activities and events held in the building must be consistent with the purpose of the P&HS, be educational or cultural in nature, and of benefit to the community. 7. A fee of $50.00 for the first hour and $25.00 for each additional hour of use, is payable the day of the event. This fee covers various costs associated with operating the building – utilities, cleaning, supplies, set-up, and personnel. Fees may be waived or reduced if the Historical Society is a co-sponsor of the event or activity. 8. Applications will be presented to Board for approval at their next scheduled meeting. Applicants will be notified, in writing’ within 5 days of the Board’s decision. 9. The Historical Society, and the applicant, retains the right to cancel a reservation. Notification of cancellations should be made in a timely manner. APPLICATION Name of Organization: __________________________________________________________________________ Contact Person: _____________________________ Phone: ________________ E-mail ____________________ Describe the planned activity or event: ______________________________________________________________ _____________________________________________________________________________________________ Date Requested: _____________________________ Time Requested: from ________ to __________ Estimated number of people who will attend: _____________ I, the undersigned, am authorized to act as representative and responsible party for the organization listed above. As the representative and responsible party, I agree to accept full responsibility for abiding by all rules and regulations established by the Pioneer and Historical Society of Muskingum County for the operation of the Stone Academy Museum. Further, I understand that my signature on this form indicates that I accept financial responsibility for any and all damage to the facility and/or artifacts within caused by the organization I am representing or any person attending the event or activity. Name (please print): ____________________________________________________________________________ Address: ______________________________________________________ Phone: ______________________ Signature: _____________________________________________________ Date: _______________________ For P&HS Use Only: ___ Approved ____ Denied (Reason for denial: ___________________________________________) Signature of Director: ________________________________________________