I have read the Facility Usage Policy
*
The facility usage policy is available on the Admin page
Yes
Group or Organization
*
UCUMC Member?
*
Yes
No
Contact Person
*
Must be present at the event.
First Name
Last Name
Contact Person's Phone Number
*
(###)
###
####
Contact Person's Email
*
Contact Person's Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Name of the Event
*
Should this event be published on the church website calendar?
*
Yes
No
Date of Event
*
MM
DD
YYYY
Event Start Time
*
Hour
Minute
Second
AM
PM
Event End Time (must be before 9:30PM)
*
Hour
Minute
Second
AM
PM
Pre-Event Set-Up Time
Hour
Minute
Second
AM
PM
Post-Event Reset Time
Hour
Minute
Second
AM
PM
If this is an ongoing event, please include start/end dates, and frequency (ex. every Monday, every other Saturday, every T/Th, etc.)
Event Description
*
Rooms Requested (if unsure, please indicate preferred size and type of room needed, or refer to the campus floor plan on the Admin tab)
*
Number of Attendees Expected
*
Is this event a fundraiser?
If yes, you must also submit the Project and Fundraising form found on the Admin tab of the website.
Yes
No
Will a kitchen be needed?
No
Yes, full service (cooking and serving)
Yes, serving only (catered event)
Are there audio/visual needs? If yes, please specify (ex. 2 microphones, projector, technician support, etc.)
Is nursery care needed? (only available to church ministry groups)
No
Yes (requires that you submit a nursery request on the Admin page)
Certificate of Liability or Hold Harmless Agreement
All OUTSIDE groups MUST submit either a Hold Harmless Agreement (see Admin page) or a Certificate of Liability (annual resubmission required, including insurer and policy number. Church ministry groups are exempt from this question.
This event is for a UCUMC ministry
Hold Harmless Agreement (submit through Admin page)
Certificate of Liability (email policy directly to RHoltzhausen@ucumc.org after completing this form)
Your Name
*
First Name
Last Name