Four Seasons at Mirage Homeowners Association

Room Use Application
Name of Group

Purpose of Meeting Is this meeting held at Mirage or offsite? Offsite Location Chairperson/Representative

Room Requested*


(Maximum of 4 Hours)


Clean-up arrangements:


Mirage Staff (Fee required)

Kitchen use required?



*If the kitchen or outdoor cooking facilities are used, please complete kitchen use checklist on the back of this form.

Approved by
Terre McCue, Community Manager

Approved by
Rebeca Mattiello, Lifestyle Director

Committee is required to clean facility after use
* Every effort will be made to accommodate your specific room request. In the event that this is not possible, an alternate location will be assigned and you will be notified of the change. Meeting rooms may be changed at the discretion of the Social Director Received Entered

1 Esplanade Drive, Barnegat, NJ 08005 609-607-1500 Fax: 609-607-0628

Committee Chair Event type Expected # of attendees A/V requirements Phone # RSD Special Requirements Set-up Time Meeting Time (Max 4 hours) Kitchen Requirements* A written floor plan is required 48 hours prior to your event *Kitchen Use Checklist The kitchen is for the use of committees. Listed below is the kitchen check list to assist in cleaning the kitchen. Counters. The deposit will be returned if the grill is left in satisfactory condition. hometown groups and clubs. Clean the floor Bag garbage and put in back room (including garbage from ballroom or lounge if applicable) Put recyclables in the appropriate containers Clean the bar area Close ice machines Check to see all lights are turned off Event OK Mgmt. sinks. counters and appliances Clean grill and stove area Confirm that oven and stoves handles are turned to "OFF" position. Items to Complete Wash and dry all dishes. The use of the kitchen must be scheduled with the Social Director and/or Management. dry and put in their boxes with all parts and put away Clean counters in ballroom Clean the sink. If the outdoor grill is requested. It is the responsibility of each group using the kitchen to leave the facility in pristine condition. Note: pilots will remain lit and oven and grill area will remain warm to the touch. a $50 deposit is required. utensils and put away Wash coffee urns. & floors must be cleaned as well as any cooking utensils utilized for the event. Return the key to the kitchen and the refrigerator/freezer to the Activity Desk with the signed check list at the conclusion of the event. OK . The kitchen will be inspected by management after the event and if the kitchen is not in spotless condition the activity will be assessed $150 for cleaning. stove. sanctioned activities. pots.

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