Facility Request Form

Name Of Applicant or Organization:

If Organization (Authorized Representative):

Address:

Phone:

Email:

Date Of Requested Use:

Starting TIme:

Finishing TIme:

Total Time:

Description of Activity:

Which Category:

Total TIme In Hours:

At This Much Per Hour:

Total Cost:

Requested Facilities (setup time constitutes use of the facilities):

By signing below I represent to the First United Methodist Church(“Church”) that, if the applicant is an organization, I am an authorized representative of that organization with authority to make these commitments on its behalf, that I have received and reviewed a copy of the Building Use Policy of Church, and I (individually and/or in behalf of the organization) accept responsibility for property damage to the property, facilities and equipment of the Church and will hold harmless and defend the Church, against any and all claims for personal injury or property damage asserted to have arisen or incurred in the course of such use(s) (EXCEPT to the extent such claim is caused by the negligence of Church, its officers, agents or employees) and agree to provide evidence of insurance or other financial capacity upon request. (Note: Church sponsored activities are covered by FUMC insurance policy)

All Activiities:

I have read, understand, and will abide by FUMC Facility Usage Policy
I have read, understand, and will abide by FUMC Safe Sanctuary Policy
I take full financial responsibility and liability for the facilities, equipment, and individuals.

Sporting Activities:

I have provided proof of liability insurance
I have provided insurance waivers/person

Kitchen Facilities:

I am aware of Fire alarms, extinguisher locations & their use
I have read, understand, and will abide by FUMC Kitchen Policy

By typing you name below you are signing this digital form for property usage. You are agreeing to all terms and conditions of this form when you submit with your name filled in below.

Applicants Signature:

Signature Date:

FUMC Contact Person:

Phone (if different than applicant):

Required field

Methodist Church

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