Belfast Edelman Sportman Association, 474 Sportsman Club Road, Nazareth, PA 18064
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BESA Club Rental Form

The undersigned hereby requests a rental of the Belfast-Edelman Sportsman Association Clubhouse:

Name:
Address:
Telephone: Home:      Work:
Place of Employment:
Date of Rental:
Rental Fees: lower floor only- $150; both floors: $200
$100 refundable security deposit
   
Fee: $
Security Deposit $100
Total Fee: $
   
Deposit: $ $100 deposit required; balance due one (1) week prior to event.
  Security deposit returned by mail one (1)week after rental date. $40.00 fee will be charged for any returned checks. The club will not hold any checks for the security deposit.

It is understood and agreed that you and your party will abide by all attached club rules and regulations. Renter will indemnify the Belfast-Edelman Sportsmen association, officers, and members; and save them harmless from and against any and all claims, damages, actions, liabilities, and expenses in connection with loss of life, personal injury and/or damage to property arising from or out of occupancy or use by renter of the premises or any part thereof. It is further agreed that permission for rental may be withdrawn by club or authorized personnel at any time without prior notice if there is a failure to comply with the rules and regulations of the club. I certify that I am at least 21 years of age.

Renter signature: _______________________________ Date: ___________

Authorized signature:_____________________________ Date: ___________

*MAKE ALL CHECKS PAYABLE TO: B.E.S.A.*

 

mail this form to :
Dean Wentzell or Jack Yuhasz c/o
Belfast Edelman Sportsman Association
474 Sportsman Club Road
Nazareth, PA 18064

 
 

2012 Club Officers

President - Dean Wentzell Vice-President - Chris Schueck
Secretary - Bob Reiss Treasurer - Jack Yuhasz
Financial Secretary- Debbie Flyte