Lake Ashuelot Estates Beach House Reservation Form   Submit this form with Security/Rental deposit check to: Lake Ashuelot Estates 263 Ashuelot Drive Washington, NH  03280

Amendment to Beach House Reservation Policy approved by BOD July 2002 Use of the Beach House is intended for LAE sponsored events. It may be reserved for family events such as birthdays, reunions, anniversaries and private parties involving LAE members and friends. Events of other organized or incorporated groups are not sanctioned. Any party who reserves the Beach House must execute a hold harmless reservation agreement and make a $50.00 dollar deposit prior to approval of the reservation. In addition a key deposit is required and will be refunded when the key is returned. The deposit is refundable upon inspection of the facility after the event. Hold Harmless Reservation Agreement By executing this Hold Harmless Reservation Agreement, the undersigned hereby represents and certifies that he/she, on behalf of all family members and guests, indemnifies and holds harmless LAE Association, its officers and directors and all members of record, from all claims whatsoever arising out of, or resulting from, the use of the LAE Beach House and the adjoining Beach Area for the function which the use of said premises is hereby reserved. ______________________________________ _______________________ LAE Member of Record (Please Print) LAE Lot Number ______________________________________________________________________ Signature ________________ ______________________________________________ Telephone Number Description of Event _______________________________ Date of Reservation = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = Office Use Only ________________________ ________________________ ______________________________ _____________________ Deposit ($50.00) Check Number Date of Check Date Returned ________________ ________________ ____________________ ______________ Key Deposit Cash/Check # Date of Check Date Returned     Regulations for Use of LAE Beach House on back side of this form. Revised 07/02 Holdharmless-revised 07/02