Request to Use/Rent the Nichols Community Center

Name *

EMail *

Home/Business Phone *

Cell Phone *

Residence or Business Address *

Mailing Address *

Are you a current paid member of FICRA?

Yes

No

If you are a Nonprofit (Tax-Exempt) Organization, provide your EIN

Contact Person at Event (name & cell phone) *

What type of event are you planning? *

How many people are expected to attend?

Are you using a caterer or other vendor(s)?

Yes

No

Will food or drinks be served?

Yes

No

Will there be alcohol at the event?

Yes

No

Will there be live music or entertainment?

Yes

No

What facilities do you plan to use? *

What are your planned hours of use? *

Half Day - 9AM to 3PM

Half Day - 4PM to 10PM

Full Day

Other (describe)Other (describe)

What date are you requesting? *

Is there an alternate date that would work?

If this is a recurring use, please describe your request

Are you able to provide the required Certificate of Insurance?

Yes

No

We require a Certificate of Insurance naming both FICRA and the FICRA Building Trust showing evidence of an insurance policy covering public liability with combined bodily injury and property damage in an amount not less than One Million Dollars ($1,000,000) for the duration of the rental period.

Do you agree to comply with all applicable laws, regulations, rules and guidelines?

Yes

No

In order to use the facility, you must comply with all of the laws of the United States and the State of Washington, all of the ordinances of Pierce County, Washington and all Nichols Community Center Facility Rules, including those pertaining to Washington State COVID 19 Guidance.

Additional Information Pertaining to Your Request

Please provide any additional information that would be helpful in understanding your request.