Epworth United Methodist Church APPLICATION FOR USE OF CHURCH FACILITIES Name of Organization or Person Requesting Space: _____________________________________________________________________________________________ Address______________________________________________________________________________________ State _______ Zip__________ Phone#______________________ Email__________________________________ Purpose of Event __________________________________________________________________________________ Day ________________________ Alternate Day________________________ Time of Event __________________________ Number of people Expected___________ Please give a brief description of people in attendance (age, any disabilities, etc.) _____________________________ _______________________________________________________________________________________________ Do you have insurance?________ You may requested to supply a certificate of insurance Name of Insurance Company: __________________________________Policy #_________________________ Do you have a Safe Sanctuary Policy? ______ If not, you will receive our policy to which you are responsible to follow SPACE REQUESTED 1. Fellowship Hall ____ 4. Other ( meeting room, stage, etc) 2. Gym ____ 3. Main Kitchen _____ _________________________________________________ Will you need tables and chairs? ______ How many? _______ Will a donation be offered to the church? _________ if yes, Amount to be offered __________________ (Suggested donation is $100 per space and a $50 deposit that will be returned if space is left clean & proper) I accept responsibility for the condition of the space requested and any damage done by the above mentioned organization or group. I understand if any damage does occur, I (responsible party) will be financially responsible for its repair or replacement. We have read and accept the church use policy on the back of this page. Signature of Responsible Party or Representative ____________________________________Date _______________ Name ______________________________________________ Phone ________________________________ -----------------------------------DO NOT WRITE BELOW THIS LINE - OFFICE USE ONLY-------------------------------------------------Is date & space available? Y N Approved__________ Denied__________ Signature Board of Trustee President ___________________________________Date Date Received ___________ Date Returned _______________ _______________ Rules and Conditions for Use of Church Facilities 1. It is the responsibility of all persons who use the property, buildings and utilities of the church to treat all possessions of the church with utmost respect and reverence. 2. NO DRUGS OR ALCHOLHOLIC BEVERAGES ALLOWED ON PREMISES. 3. NO SMOKING allowed inside the building. 4. No event will start before 8AM nor run beyond 10PM. Any violation of this will result in loss of deposit. 5. A safe sanctuary policy is to be in affect at all times for those under 18 years. 6. Children should not be allowed to run around the building. Any damage will be the user’s responsibility, as stated on the signed application. 7. All chairs, tables, furniture used must be put back in their original place. 8. All garbage must be tied and bagged and put in the trash cans outside. Your garbage must be picked up from outside as well. 9. The hall, room and kitchen floors must be kept clean. 10. Check restrooms for cleanliness. Make sure all water faucets are turned off in the bathroom and kitchen areas. 11. PLEASE TURN OFF ALL LIGHTS AND FANS (including restrooms). 12. Windows must be closed and locked. 13. Heat and air conditioning is for needed hours only. Please remember to turn it back when leaving. 14. If kitchen is used, it shall be cleaned and put back in its original condition. Make sure all stove burners are off. 15. Nothing is to be removed from or to be left in the refrigerator. 16. Epworth is a Styrofoam free facility. Please refrain from using Styrofoam products. 17. User is not permitted to use church utensils, dishes, or coffee-making machines. 18. Only occupy the rooms that you have requested to use.