Facility Use Request & Agreement (old, do not use)

Your name *

Email address *

Phone number *

Address *

What is your affiliation with Jerome Church? *

Please choose your affiliation that applies to this facility use.

Tell us about this facility use request

What type of function will be using the Jerome Church facility? *

Please briefly describe the function using Jerome Church below.

Is this a one time or recurring event usage request? *

What space(s) are you requesting? *

Please check any spaces that you are requesting to use.

Gym

Sanctuary

Lobby (please request if using Gym and/or Sanctuary)

Kitchen

Large Group Space (Room 105)

Parking Lot (check if using for more than event parking only)

Conference Room

Nursery Classroom

Preschool Classroom

Other Classroom

Other

Who will be attending?

Please include the approximate number of adults AND children (under age 18) who will be attending this event at Jerome Church.

Number of adults attending *

min: 0 / max: 150

Please include an estimate if exact number is unknown.

Number of children attending *

min: 0 / max: 150

Children are those under the age of 18. Please include an estimate if exact number is unknown.

Facility Use Fees, Guidelines & Liability Waiver

Please check the boxes below and include your digital signature to agree to the facility fee(s), guidelines and authorization and liability waiver.

Facility Use Guidelines *

Please read the below guidelines pertaining to facility use at Jerome Church:
1. Users of the church facilities agree to the utmost care in the use of church facilities and agree to leave the facilities in good, clean condition. Please note that additional fees may be incurred for facility damage and/or cleaning according to the Fee Schedule.
2. Church equipment, such as tables and chairs, must be requested within this form, and shall be returned to original placements, unless otherwise arranged prior to the event.
3. For events where children and youth are present, the applicable group or organization must provide adequate adult supervision (at least 2 adults per group) for all usage.
4. Church does not supply linens, tableware (plates, utensils, cups, etc.)

Authorization & Release of Liability *

In the above facility use agreement, the group/organization and person responsible ("User") specified in this form agree to use Jerome United Methodist Church (Jerome Church)'s facilities, with the full knowledge that losses or liability incurred by the User are not covered by Jerome Church.

The User understands that the responsibility to obtain liability and property insurance is upon the User. Is is not the duty or responsibility of Jerome Church to insure the User's use of the facilities. It is recommended that the User obtain its own liability and property coverage for its use of the facilities, and provide and documentation as such to the Jerome Church office.

Signature *

By writing your full name below, you are stating that you are the User or an authorized representative of the User, and understand and are agreeing to the terms of fee structure, use guidelines and the authorization and release of liability.

Please write your full name below: