Mariemont Church Building Usage Form

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Todays Date *

YYYY

Requester Name *

Requester Phone *

Requester Email *

Sponsor Name (Sponsor must be church staff or church member and can be same as requester) *

Name of your Group or Event *

Which Room(s) are You Requesting (Please note that, unless specified and approved in the notes below, all areas must be returned to their original setup and condition after use.) *

Emery Room

Meeting Room (Do not move furniture with glass tops)

Auditorium & Lobby

Baker Room (Do not move furniture with glass tops)

Hearth Room

The Rock

Youth Room

Game Room

Library

Room 101 - Muscle Room

Room 102

Room 103

Room 104

Room 105

Room 106

Room 107 - Nursery

Room 108 - Upper Elementary

Required

Date(s) & Time(s) Requested (Include specific date, recurring days and times) *

Group Size *

Room Setup Requests or Notes about Your Group or Event.

Which Doors Need to be Unlocked (Choose only if needed) (doors unlocked 30 prior and 30 after event start time)

Emery Room Door (South Entrance)

Office Door (North Entrance)

Kids Door (Lower Lot Entrance) (Handicap Access)

Our Organization Carries Liability Insurance? *

Yes

Conditions of Building Use:

CLEANING: Groups are required to clean and return areas used in the same condition they started in.

GLASS TOP TABLES in the Meeting Room and Baker Room: These tables MUST be moved only by MC staff. The glass can SHATTER if the edges touch. $480 replacement cost.

SIGNS ON LAWN, WINDOWS AND INTERIOR WALLS: Signs are not permitted without the advanced prior approval of Mariemont Church. Approved signs are to be provided by the meeting group and removed at the end of each meeting.

The use of ALCOHOLIC BEVERAGES or ILLEGAL DRUGS is not permitted on church premises or on the grounds at anytime.

SMOKING or VAPING in the facilities or on the grounds: There shall be NO SMOKING or VAPING or use of tobacco in the facilities or on the grounds at anytime.

I understand and abide with these conditions

Required

AGREEMENT AND INDEMNITY: I/we have read MC's Building Use Policy (available in main office) and agree to abide by this policy for the event(s) and arrangements stated on this form. I/we hereby agree to release, indemnify, and hold harmless Mariemont Church, its pastors, officers, agents, employees, and members from any and all claims, damages, liabilities, judgments, losses, and injuries, including but not limited to personal injury and property damage, arising from or related to this use of Mariemont Church facilities or property.
*

I understand and abide with these conditions

Required

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