Building Use Form

Name of Group or Organization

Purpose of Building Use

Date of event

Start Time (include set up)

End Time (include clean up)

Contact Information

Contact Name

Contact Email

This address will receive a confirmation email

Contact Phone #

Address

Space Requirements

Check all that apply:

Sanctuary Fellowship Hall Peace Cafe Large Classroom Conference Room

Equipment Requirements

Serving Help

Do you need help with special set-up, take-down, custodial clean-up, or serving (note: there is an additional fee for this)?

Yes No

If yes, please explain:

Additional Information

Estimated number of attendees:

Plans for entering/locking building (note, an adult must be in the building at all times the building is unlocked).

Will food and/or beverages be served?

Yes No

If yes, please explain (i.e. snacks, potluck, banquet, etc). Note: No alcoholic beverages permitted without MB approval)

Additional Information

Please include any additional information we should know or questions you may have.

Donation

The following is the suggested "Donation Schedule" for use of the facilities of Peace Lutheran Church by a group/organization based on a normal usage of up to 4 hours duration. The Ministry Board will negotiate requests for longer usage.

Facility Use - $150 (allowing 4 hours of use; facility use fee waived for Peace Lutheran Church members)
each additional hour - $50 (negotiable if know prior to the date of the event)

*Please contact the church office regarding additional fees such as pastoral honorarium; church piano/organist; and building set-up, take-down, cleaning, & serving fee.

Checks can be mailed or dropped off at the church office.

Hold Harmless Agreement

The users of the facilities will be expected to clean up after themselves, put building equipment back in original set-up, and to secure the facilities before leaving. Alcohol is not permitted unless approved by the Ministry Board. Smoking is not permitted anywhere on the premises. Users of the facilities are responsible for reimbursing PLC for damaged or lost property and unreturned key. Contact the office with questions and requests.

_____________________________

The user of the facility agrees to hold Peace Lutheran Church harmless from all claims arising from Users use, conduct, or management of facility, grounds, or contents, including damage to or theft of or to property, when such claims arise out of the acts of omissions of User or usage by User. User further agrees to hold the Church harmless from all costs, attorney’s fees, expenses and liabilities incurred in connections with such claims. The User, represented by the undersigned, agrees to observe all existing Board policies and Church Building Use Policy, copies of which are the responsibility of the User to acquire. The User acknowledges the Church’s right to revoke the further use of any assigned facility from the User without notice to the User. The User may not transfer, misrepresent, or abuse scheduling requests without written consent of the Church. Signature below indicates a guarantee by the signee that all users and families have been informed of and agree to the above, and to comply with the rules of usage as described in the church’s Building Use Policy.

I have read and agree to follow the Peace Lutheran Building Use Policy (a copy can be found at www.come2peace.com/facility-rental).

Yes

Building Use Form

Description

Please Fix the Following