Facility Use Application (Part 1 of 2)

Applicant Name or Group Representing:

This address will receive a confirmation email

Phone

Address

Name of Event:

Date(s) of Event:

Time (start and end):

Day of Event Set Up Time:

Estimated Attendance

Children present?

Yes No

Requested UTBR facility space (check those that apply) UTBR reserves the right to make the final decision on space:

Sanctuary (30+ in attendance) Community Room (up to 30) Outdoor Patio (seats up to 224) Kitchen

Request for (check any that apply): Note that use of sound or video equipment requires UTBR sound/video engineer.

Microphone/PA system Computer/Powerpoint Videographer No services needed

Facility Use Agreement

Please check off each box below to confirm you have read the below:

All reserved areas must be left as found. The renter is responsible for setup, breakdown, and returning furniture to its original position unless arranged with UTBR. No alcoholic beverages or smoking on church property at any time. No food or beverages in the sanctuary. Any damage, or replacement costs due to food/beverage will be the responsibility of the applicant. Damage to the church property caused by the applicant and/or program participants or any person attending the event for which the church was rented, will be charged to the applicant. Certain events may be required to provide event insurance of up to $1,000,000,000. Resource: https://jauntin.com/event-insurance-in-north-carolina/ Once your application is approved, an non-refundable (less than 45 days) application fee of $75 is due to hold your date and space.

A nonrefundable deposit must accompany this application to be considered for use of our facility. $75

Fees

For Administrative Purposes:

Office Staff: Received by Date Reviewed Approved

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Facility Use Application (Part 1 of 2)

Description

Please Fix the Following