аЯрЁБс>ўџ >@ўџџџ=џџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџьЅС` љПR)bjbjЫsЫs 40ЉЉR 8џџџџџџЄRRRRRRRfЪ Ъ Ъ 8 $& fRЖN N N N N ) Bk ,— ‰‹‹‹‹‹‹$hpzЏ]RЏ ) ) Џ Џ ЏRRN N л Џ ‚RN RN ‰Џ ‰RRN B PЦ3<оЩЪ 1 ju"0Rъ› ъъRXЏ Џ Џ Џ Џ Џ Џ ЏЏГjЏ Џ Џ RЏ Џ Џ Џ fffdЪ fffЪ fffRRRRRR  FACILITIES CHECKLIST INSPECTION OF PREMISES FOR CONDITIONS OF SAFE USE Facilities Checklist: This is a suggested facilities checklist. It is recommended that before each dance, the facility should be checked and items that are not in proper working order should be noted and brought to the attention of the custodian before taking possession of the facility (dirty, sticky floors; loose tile or floor boards; parking area lighting and condition, etc.) The form should be made in duplicate (original to custodian, and have him sign and date your copy). If this is not done, the club or organization could later be billed for repairs or cleaning; or worse, held liable if condition of facility is inadequate for dancing and an accidental injury is sustained by a dancer as a result of faulty conditions. If you are filling this form out on the computer, use your tab key to move from field to field. Use your F1 key for information about each field. Name of Square Dance Club  FORMTEXT       Dance Location:  FORMTEXT       Parking Lot Area  FORMTEXT       Entrance Area & Floor  FORMTEXT       Dance Floor  FORMTEXT       Caller s Area on Stage  FORMTEXT       Kitchen  FORMTEXT       Dining Room Area  FORMTEXT       Restrooms  FORMTEXT       FH]^g‰Ё  & К Л е ж р с  р ю ў   $ & ( 2 4 ђєњєяычычытыоыквЮУвкОкКБЋ™Œt™]™XБєКы h q>*-jh{6M5OJQJU^JaJmHnHu.jŠh{6Mh%A@5OJQJU^JaJh{6M5OJQJ^JaJ"jh{6M5OJQJU^JaJ hЌlCJh"1њh=yДCJh=yД hЌl>*jh%A@Uh{6Mjh{6MUhЌlhl+з h"1њ>*h qh"1њ h"1њ5 h=yДCJ h=yД5"GH& ' К Л т є4DhpŠ’ Ў!К"ж#їїїууудШРДДДДДДДДДД „hdh^„hgd"1њdhgdЌl  ЦаdhgdЌl$ Цаdшўa$gd"1њ$ Ца&dPЦџa$gd"1њ$a$gd=yДр(P)ўў.02<><>@TVXbd2JNPdfhrtBprtˆŠŒ–˜fh|~’”– Ђnp’”ЈЊќє№хєзєвЮ№є№УєзєвЮ№ЛќАЛЂЛвЮќЛќ—ЛЂЛвЮќЛќŒЛЂЛвќЮќЛќjФ hЌlUjThЌlUjфhЌlUjhЌlUmHnHuj~h%A@UjhЌlUjh%A@Uh=yД h q>*jh"1њUmHnHujžh%A@Uh"1њjh"1њUhЌl2ЊЌЖИˆœЂЄИКМЦШ  И М О в д ж р т Ќ!Р!Ц!Ш!м!о!р!ъ!ь!И"к"м"о"ђ"є"і"##д#|%&&B&Ј&Ж&К&М&О&Ц&Ш&Ъ&о&р&т&ь&ю&їщїфрмїмбїщїфЯфрмїмФїщїфрмїмЙїщїфрмїмЎїщїфрЉрЉрмЄмр їм•їщїjєh%A@Uhl+з hЌl>* h=yД>*j„hЌlUjhЌlUjЄ hЌlUUj4 hЌlUhЌlh=yД h q>*jhЌlUmHnHujhЌlU: Lighting Facilities  FORMTEXT       Furniture  FORMTEXT       Windows & Drapes  FORMTEXT       We have inspected the square dance facilities provided for our use, both before and after the conclusion of our dance. We find all conditions to be normal and acceptable for safe use, except as noted above. Signed Date  FORMTEXT       Signed Date  FORMTEXT       Complete duplicate copies: One for Club & One for Custodian.     NCSDA Insurance Fill in Form August 2008 ж#и#к#z%|%Њ&№&ђ&є&`(b(d(f(р(ф(ц(ъ(ь(ііъъънннаПВЉš˜˜˜˜$ Цаdшўa$gdl+з Ц gd=yД  Ц€И <gdl+з Ц€И <„€^„€gdl+з  ЦИ <gdl+з  ЦТИ <gdl+з  Цаdшўgd=yД Цdgd=yДю&№&є&ž'К'($(((*(,(4(6(8(L(N(P(Z(\(^(о(р(т(ц(ш(ь(ю(ђ(є(ј( )")B)J)N)P)R)їѓюѓюѓъхъѓсйъЮйРйъѓЙБ­Б­Б­Б­ЉЅЉЅЉ­Йh"1њhУkТhЄZлjhЄZлU h=yДhќ_:jhЌlUmHnHujhЌlUjhЌlUhl+з hЌl>*hЌl h=yД>*h=yДhl+зh=yД>*#ь(№(ђ(і(ј(L)N)P)R)§§§§ы§§м$ Цаdшўa$gdl+з ЦР!$$dNЦџgd#6#2&P:p#6#Аа/ Ар=!А "А #а$а%ААhАh аŠDџџџџ€7Text5 UPPERCASEAEnter name of club renting facility. DO NOT USE ABBREVIATIONS.AEnter name of club renting facility. DO NOT USE ABBREVIATIONS.Dџџџџ€ FIRST CAPITAL$Name and address of hall being used.$Name and address of hall being used.pDџџџџ€Text2?Enter conditions of area. If there is any damage, list it here ?Enter conditions of area. If there is any damage, list it here pDџџџџ€Text3?Enter conditions of area. If there is any damage, list it here ?Enter conditions of area. If there is any damage, list it here fDџџџџ€?Enter conditions of area. If there is any damage, list it here ?Enter conditions of area. If there is any damage, list it here pDџџџџ€Text3?Enter conditions of area. If there is any damage, list it here ?Enter conditions of area. If there is any damage, list it here pDџџџџ€Text3?Enter conditions of area. If there is any damage, list it here ?Enter conditions of area. If there is any damage, list it here pDџџџџ€Text3?Enter conditions of area. If there is any damage, list it here ?Enter conditions of area. If there is any damage, list it here pDџџџџ€Text3?Enter conditions of area. If there is any damage, list it here ?Enter conditions of area. If there is any damage, list it here pDџџџџ€Text3?Enter conditions of area. If there is any damage, list it here ?Enter conditions of area. If there is any damage, list it here pDџџџџ€Text3?Enter conditions of area. If there is any damage, list it here ?Enter conditions of area. If there is any damage, list it here pDџџџџ€Text3?Enter conditions of area. If there is any damage, list it here ?Enter conditions of area. If there is any damage, list it here $Dџџџџ€Text4MM/dd/yy(Enter date of dance. FORMAT MM/DD/YY.(Enter date of dance. FORMAT MM/DD/YY.$Dџџџџ€Text4MM/dd/yy(Enter date of dance. FORMAT MM/DD/YY.(Enter date of dance. FORMAT MM/DD/YY.†œH@ёџH =yДNormal5$7$8$9DH$_HmH sH tH DAђџЁD Default Paragraph FontRiѓџГR  Table Normalі4ж l4жaі (kєџС(No List8ўOђ8 =yД Default TextCJ4 @4 =yДFooter  ЦрР!4@4 =yДHeader  ЦрР!‹ 0џџџџGH&'КЛS\ы|–Ї+ Й ? 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