Application for Building Use at Gloria Dei Lutheran Church

Approved April 24, 2018

Today's Date

Contact Information

Name of Organization

Name of Contact Person

Address

This address will receive a confirmation email

Phone

Membership

Yes, I am a Gloria Dei Member No, I an not a Gloria Dei Member Someone on our team is a Gloria Dei Member.

Event Information

Event Date(s):

Alternate Event Date(s):

Event Time(s): include AM/PM

Purpose of Event:

Any Admission fee for the event?

No Yes

Event to be used as a fundraiser?

No Yes

Anticipated Attendance:

Room(s) Needed:

Equipment Needed: (chairs, tables, video equipment, lectern, piano, etc...)

Comments:

Attach File (optional)

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RELEASE of LIABILITY

Participants using the facilities of Gloria Dei Lutheran Church, and all accompanying activities associated with its use, voluntarily waive any right or cause of action, of any kind whatsoever, arising as a result from such participation from which any liability may or could accrue to Gloria Dei Lutheran Church and the individuals thereof. Gloria Dei Lutheran Church will not be held responsible for loss or damage to any personal property brought into the facility.

I have read the Building Use Policy; and, together with all the members of the group I represent, do agree to adhere to the policies, guidelines, and procedures set forth in it. Use is permitted only in the area(s) on the date(s) and time(s) indicated above.

For safety and building security, doors are not to be propped open at any time.

I agree to not propping any outside doors at Gloria Dei. I/We understand that propping doors will result in loss of security deposit and future use of the building at Gloria Dei.

Electronic Signature:

Electronic Signature Date:

Description

Please fill out this form and click submit.

Application for Building Use at Gloria Dei Lutheran Church

Description

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