Building Use Form – Peace Lutheran Church

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Property Use Agreement and Release Form for Peace Lutheran Church

Adopted by Church Council on February 16, 2016

Name of Organization

Responsible Person

Address

Contact Person's Name

Email Address

Day Phone

Cell Phone

Fax

Organization's Purpose

Non-Profit Status

ID Number

Start Date

Start Time

End Date

End Time

Frequency

One Time Weekly Monthly Other

If you selected other, please specify

Which Day(s) of the Week?

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

In detail, describe the type of event you will be brining to our facility

Will tickets be sold, or admission charged for your event?

Yes No

If yes, what will be the ticket price?

If yes, what will the proceeds be used for?

CERTIFICATE OF INSURANCE REQUIREMENTS - Non-church groups are required to provide certificates of insurance naming Peace Lutheran Church as additional insured. A certificate should be turned into the church office at least a week before the first use. For continuing usage, the form should be renewed annually

I Agree

Room(s) Requested