Building & Grounds Use Request Form
Requests for using First Congregational Church facilities.
List Event or Meeting Date(s):
Start Time of Event or Meeting(s):
End Time of Event or Meeting(s):
Contact Person's Address:
Contact Person's Phone(s):
Contact Person's Email Address(s):
Our Group Meets:
One Time Event Use
Approximate Number Attending
Purpose of the Event or Meeting(s)
Will Food Be Served?
Room(s) Needed: (Please check all areas needed)
Parlor Room (sitting room upstairs across from Sanctuary w/ small kitchenette)
Library (seating area outside of Sanctuary w/ coffee bar)
Office Conference Room
Large Dining Room (downstairs)
Son Cafe' (downstairs)
Plymouth (Bridal) Room (downstairs)
Full Kitchen (downstairs)
CE Wing Classrooms (downstairs)
Board Room (downstairs classroom 4,5,6)
Mitchell Youth Room (up upstairs)
Choir Music Room (up upstairs)
Equipment Needed: (Check all needed)
Sound Equipment (speakers)
I/We understand and agree that not either the Church, it's trustees, representatives, employees, or agents may be held liable in any way for any occurrence in connection with the FCC Building & Grounds Use stated above, which may result in injury, harm, or other damages to the undersigned or members of our organization and guests, invited or not, or myself. Rather, I/We agree that our organization or myself alone shall be responsible for any property damage, personal injury, or death that may occur during our/my use of the premises. As part of the consideration for being allowed to use FCC facility, building, and grounds as well as all appliances and fixtures of FCC that I/We may use, I/We release the Church, it's trustees, employees, agents, and representatives from any claim for damages, injury, or death which may occur while participating in the FCC Building & Grounds Use as stated above. I/We further agree to save and hold harmless the Church, it's trustees, employees, agents, and representatives from any claim arising out of our/my participating in any form or fashion in the FCC Building & Grounds Use stated above. I/We represent that our organization/myself has general liability insurance with enough coverage limits that are in effect as of the date of the FCC Building & Grounds Use request stated above in the form. I/We further state that I/We are authorized to agree to this Building Use agreement; that I/We understand the terms herein are contractual in nature and not mere recital; and that I/We have signed this document of our own free act and volition. I/We further state and acknowledge that I/We have fully informed ourselves/myself of the content of this affirmation and release by reading it before I/We agree to it.
I/We have read the FCC Building & Grounds Use Policies.
I/We agree to abide to all FCC Building & Grounds Use Policies as stated.
By typing my name below, I am stating that I am a representative of the organization stated above or myself and I agree to all policies and liability releases as stated above. I will be responsible for my organization's or my use of First Congregational Church's Building & Grounds Use, as stated above in the request form. I will be responsible for making sure that all policies are read and followed while using the FCC Building and Grounds. Please type your name, organization's name, title, and date below to agree.
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