Memorial Lutheran Church

Office: 2602 E. 28th St., Vancouver WA 98661

360-695-7501 (M-F, 9-1) Email: office@mlc.org

Application: Lease or Rent Memorial Lutheran Church Properties

Updated: 7/2017 (5 pages)    

Use of Memorial Lutheran Church (the Church) Facilities and Properties is a closely controlled privilege that may be rescinded or modified at any time by the Church’s leadership team.

Changes in this information require written permission to proceed.  Also, changing this information will impact other groups.

Section 1 of 12: Failure to complete this section the application will not proceed or may be denied.

Today’s Date:  __________________

Name of Group:  _____________________________________

Applicant Information:

      Name: _____________________________________________

         Title within this Group: ________________________________

         Contact Phone:_______________________________________________________

         Contact Email:_______________________________________________________

         Mailing Address: _____________________________________________________           

                   City: _______________________________ Zip Code: _____________

I am a member of Memorial Lutheran Church:  Yes     or       No  

Section 2 of 12: If available provide the following information:

Federal Government 501 (c) 3 tax exemption number: ___________.

Washington State Business License number:____________ .

Describe your group’s affiliation, if not Memorial Church sponsored: ________________________________________________________________________

Section 3 of 12:  Contact information will be use if there is a need to change your use of the Church property.

Emergency (Secondary) Contact: Name:_______________________________________

 Email _________________________________  and Phone _______________________

Section 4 of 12: Failure to complete this section the application will not proceed or may be denied.

Time “Staff” Enter and Leave, Locking the Building: ______________________

Section 5 of 12: Failure to complete this section the application will not proceed or may be denied. 

Complete one that describes your authority and legal authorizations:

I, ______________________________________________(Print Name),

  1. (Initial)________, have the authority and am legally authorized to:
  • Act as the Responsible Representative of my group and have the group’s legal authorization to sign and provide all documents requested by Memorial Lutheran Church.
  • I realise that I will be held accountable to enforce Memorial Lutheran Church, Facilities  and Properties Use: Requirements Procedures and Guidelines, and that failure to enforce the Policy and Requirements could result in termination of all agreements.
  • I will be attending all planned activities:  Yes  or  No  
  1. (Initial)________, have no authority or legal authorization to meet any of the Memorial Lutheran Church requests or requirements.

Provide the contact information for the person who has the authority and legal authorizations to act as the Responsible Representative:

Name:  __________________________________________________

Title: ___________________________________________________

Email: __________________________________________________

Phone: __________________________________________________

Section 6 of 12: Failure to complete this section the application will not proceed or may be denied.

Describe Proposed Activity (This information will define the constraints place on this application.  Failure to provide adequate information will delay this process.)

_____________________________________________________________________ _____________________________________________________________________

_____________________________________________________________________

Circle desired property(ies):

  • Memorial Parish Hall….
  • Parking Lot….  
  • Parking lot & Playground
  • Other:

I currently have a key/card: Circle one;     Yes     or      No    

Section 7 of 12: Failure to complete this section the application will not proceed or may be denied. Also, Changes in this information requires submission of a new Application: Lease or Rent Memorial Lutheran Church Properties Note: Assignment of space is at the discretion of the Facilities Coordinator. 

Choose Only One, Fire Code Restricts Occupancy by Group Size:

  1. Attendance will never at any time exceed 10 people: I agree my groups will not exceed 10 People _______ (Initial)
  2. Attendance can be 11 to 130 People.  Estimated Attendance:__________

Section 8 of 12: View Memorial Church property schedules at www.mlc.org, “Facilities and Properties Use” for available space before completing this section or email Facilities Coordinator to see if dates are available. Failure to complete this section the application will not proceed or may be denied.

Choose One: Note: Do not offer "either, or” situations.

  1. One Time Activity/Venue:   Date _______________________
  2. Same Activity/Venue Occurring Two or More Times:
  • Activity Start Date:______________Day(s) of the week_____________
  • Activity Frequency: Circle one    Daily        Weekly         Monthly

Section 9 of 12:   Equipment: The Church provides some equipment that your group is to set-up, per the Church Board of Directors.  We can not honor requests for special or specific equipment. Note: Failure to complete this section tables and chairs will not be available. 

  • Tables Round:#__________  Without Chairs or with chairs
  • Tables Rectangle:
  • #6 ft _________ Table   Select: Without or with chairs,    one or       both sides
  • #8 ft _________ Table   Select: Without or with chairs,    one or       both sides
  • #4 ft _________ Table   Select: Without or with chairs,    one or       both sides
  • 2x4 ft Drinks Table: #_____________________________________
  • Extra Chairs#__________________________________________________  

Section 10 of 12:  General summary of requirements for use of Memorial Lutheran Church Facilities and Properties: Application to Lease or Rent.. Further requirements and details found in the Memorial Lutheran Church Facilities and Properties Use: Requirements, Procedures and Guidelines. (mlc.org)

  1. All use is under the constraints describe in Memorial Lutheran Church Facilities and Properties Use: Requirements, Procedures and Guidelines (See mlc.org, Facilities Use)
  2. Keys are issued only by written request through lifesafety@mlc.org. No exceptions.
  3. Required Documents (Upon request):
  1. Authorized Representative Agreement(signed originial)
  2. Statement to Indemnify and Hold Harmless (notarized original)
  3. Insurance: 
  1. See Facilities and Properties Use: Requirements, Procedures and Guidelines, Section 2, Insurance; Certificate of Liability Insurance and Commercial General Liability Broadening Endorsement  
  2. All endorsements and supporting policy provisions of the insurance
  1. Requested Minimum Donation
  2. Requested Refundable Deposit
  3. Any other requested documents

Section 11 of 12:  The process may take up to 30 days as the application and documents are reviewed and may be submitted to the Church Board of Directors for a decision.  A letter/email will sent when a decision is made.

Questions: mlcfacilitiesuse@gmail.com 

 

Section 12:  Submit original documents, when required, to the Church office, Memorial Lutheran Church Office: 2602 E. 28th St., Vancouver WA 98661,  360-695-7501 (M-F, 9-1) .

Thank you, Memorial Lutheran Church and Facilities Coordinator

End Document: Application: Lease or Rent Memorial Lutheran Church Properties

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