BUILDING USE FORM | Church of Reconciliation

Building Use Form

Name of Applicant or Group

Name of Person Responsible:

Phone( ) -

Desired Date of Event:

Time Needed:

Description of Event's Purpose

If Other, please specify below:

Number of People Expected:

Is there anything else you might need for the event, or anything you need for us to know?

Will alcohol be served at this event (beer and wine only)?:

Yes

I will meet with a staff member before the event to receive the door code, key, and/or alarm codes to the room I will be using.

Yes

I agree to pay the fees that will be due after a staff member has reviewed my application

Yes

I have read and understood the building use policy for The Episcopal Church of Reconciliation and hereby agree to confirm to its regulations. I understand that I am liable for any damages incurred to the above listed building(s) during the event.

Yes

Electronic Signature (please type name below):

Today's Date

Please leave this field blank.