Grace Episcopal Church Covid-19 Facilities Use
Thank you for connecting with us! We are happy to share our space with you.

Please complete this form carefully.
If you have question, you may contact our office manager, Sarah Neidhoefer, at office@grace-espicopal.org.
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Email *
The name of your organization (if applicable):
Your last name: *
Your first name: *
Best way to contact you: *
Please provide contact information for "best way to contact you": *
Which space of the Grace Church campus are you hoping to use? Please check all that apply. *
Required
If you marked "other" please indicate what space you would like to use
What date are you hoping to schedule for your event? (If this is a request for an ongoing use of space, just choose the first date you want to start using the space.) *
MM
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DD
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YYYY
What time will your use begin? *
Time
:
What time will you leave the space you are hoping to use? *
Time
:
Is this a one-time, ongoing or indefinite use of the space(s)? *
If on-going but not indefinite, for how many weeks/months would it continue?
How many people will be present? *
If you marked "other" above, please note the expected number of people and an explanation.
From how many households will these people come? *
From how far will people have travelled to participate? Mark the furthest distance you expect any participant to travel. *
Please list the approximate ages of those who will be present. Check all that apply *
Required
From which of the above age groups are most of your participants? *
How many people will be fully vaccinated? Please estimate to the best of your knowledge. *
How many people will be partially vaccinated? Please estimate to the best of your knowledge. *
How many people will be unvaccinated? Please estimate to the best of your knowledge. *
What are the planned activities? *
Have you confirmed that these activities and any gathering among households that they entail are permissible under California's Blueprint for a Safer Economy? https://covid19.ca.gov/safer-economy/ *
Will it be possible to maintain 6 feet of distance between households? *
Will it be possible to conduct the planned activities while masked? *
Will there be singing or wind instruments playing at the event? *
Are those singing or playing fully vaccinated? *
Are they able to sing while masked or cover the air egress of the instrument? *
Please sign this form with your full name and the name of your organization (if applicable) to indicate that you understand that you agree to abide by Grace’s COVID-19 protocols and  will be responsible for ensuring that all present at your planned activity abide by Grace’s COVID-19 safety protocols while using the campus.  You assume all liability associated with your use of the facilities, and may be required to show proof of insurance.  Submitting this form does not ensure approval of your requested use; you will be notified of approval and specific COVID-19 safety protocols for your event, which may include: distancing, masking, ventilation, indoor vs. outdoor use, testing and/or vaccine verification.  Permission for use and specific COVID-19 mitigation measures are subject to change based upon the changing conditions of the pandemic. *
Thank you for completing this form!
Our office manager will get back to you shortly after sharing your request with our team.
Bless you!
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This form was created inside of Grace-Episcopal Church.