SALISHAN LEASEHOLDERS, INC.
P.O. Box 219
Gleneden Beach, Oregon 97388
Telephone: 541-764-2208 Fax: 541-764-2206
Leaseholder Name__________________________________________________________________________
Name of Group__________________________________________________________________________
Date(s) Requested__________________________
Time: From:______________to______________
Purpose________________________________________________________________________
Number in Party____________
Facilities Requested:
Clubhouse _____ Swimming Pool _____ Set Up _____
In signing this request, it is understood that the $100.00 cleaning deposit will be refunded after the facilities have been inspected by the Manager.
In consideration of allowing leaseholder use of the recreation facilities of Salishan Leaseholders, Inc. (SLI), leaseholder agrees to indemnify, defend and hold harmless SLI, its members, employees, officers and directors from and against all actions, claims, liabilities, damages, costs and expenses including but not limited to attorney fees and court costs, which in any manner may arise or be alleged to have arisen or resulted from activities of any nature on the part of leaseholder and/or his or her guests and attendees, including, but not limited to, claims for bodily injury, death or damage to property.
Dated this ______day of __________________________20_______
____________________________________________________
Leaseholder Signature
Clubhouse - Swimming Pool - Set Up -
Family or leaseholder guests $25.00 First 4 hrs. $35.00 $25.00
Nonleaseholder guests $50.00 First 4 hrs. $50.00 $25.00
Additional hours over four: _____@ $10.00/Hr. = $______
Cleaning Deposit - $100.00
Total Amount $_____________
