Pender Resource Request Form

Pender Resource Request Form

For Pender and Pender-Sponsored Activities
Your Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Emergency Contact If Pender needs to close for snow or other emergency.*

First NameLast Name
Emergency Contact E-mail*
Second Person
Emergency Contact Phone Number*

Area CodePhone Number
Your Organization name and mailing address.
Name of Event
Event Description
First Meeting Date

MonthDayYear
Date
Do you need time to set up?*

YesNo
If yes, what time should that start?

:HourMinutesAM/PM Option
Meeting start time

:HourMinutesAM/PM Option
Meeting end time

:HourMinutesAM/PM Option
Do you need time to clean up?*

YesNo
If yes, when do you estimate you'll finish?

:HourMinutesAM/PM Option
Does this event repeat? If so, how often?
Ending Date

MonthDayYear
Date
How many people do you expect?
First and second preference of room/space. Note that you may be assigned to another room at any time
The undersigned represents and warrants that he/she is an authorized agent of the organization set forth above (hereinafter “Organization”) with full power and authority to execute this agreement on behalf of the Organization.

In consideration of Pender furnishing or making available property (real and personal), facilities, services, resources, supplies, programs and/or equipment (hereinafter “Church Property”) to the Organization, and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the undersigned, individually and on behalf of the Organization, assumes all risk, responsibility and liability for any and all injuries, dangers, loss or damage of any nature whatsoever, which occur, arise from or are related to the use of Church Property by the Organization and/or failure of any attendee to fully comply with all terms and provisions of the Policy.
Please sign your name.*

Clear
Should be Empty: