Lake Miramichi

Clubhouse Use Contract

Note: It is a requirement that membership dues be paid in full to have access to the LMPOA clubhouse.

First Name

Last Name

Mailing Address

Date of rental

What time?

The resident above is requesting the use of the LMPOA clubhouse on the date listed on this form. I understand that there is a $200.00 deposit required prior to the date of use. The deposit will be refunded or returned as long as the clubhouse is completely cleaned up after your event.

Mail the deposit check along with this form to: LMPOA P.O. Box 916 Evart, MI 49631

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