Rental Application/Agreement

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Wesley United Church, 3913 Hillsdale St, Regina SK S4S 3Y6

Email *

User Group/Organization/Event *

Contact Person(s) *

Mailing Address *

Phone *

Start Date *

YYYY

Time of Arrival (includes setup) *

Time

End Date *

YYYY

Time completed by (includes teardown) *

Time

Number of people expected *

Rooms Requested *

Sanctuary/Auditorium* (Extra charge may apply for usage of the piano in this room)

Kitchen

Kitchen Lounge

Room 107

Room 105

Room 104 (Available evenings, except Mondays)

Required

Equipment Requested *

Dishes/Utensils (with Kitchen rental)

Coffee Urns (with Kitchen rental)

Stoves (with Kitchen rental)

Refrigerator (with Kitchen rental)

TV Systems (A/V rental in Sanctuary only)

Microphone (A/V rental in Sanctuary only)

Screen (A/V rental in Sanctuary only)

Other:

Required

PLEASE READ

On behalf of the User Group/Organization listed above, I/we hereby make application for the use of the facilities indicated for the purpose, dates, and times specified. As per my/our signature(s) below, I/we heregy agree to comply with all the attached "Terms and Conditions of Use", including the Fee and Deposit Schedule, as well as any supplementary letter of Understanding which may accompany this agreement.

Should the said User Group/Organization be granted use of the facilities requested, it is further agree and understood that said User Group/Organization and participants shall save harmless and indemnify Wesley United Church against all claims, liabilities, demands, damages, or rights, or causes of action whatever, made or asserted by anyone arising out of or incidental to this application or to the use and occupancy of the permitted facility and premises.

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