The Livin Room Building Usage Request Form

The Livin Room Building Usage Request Form

Thank you for your interest in booking our facility for an event/meeting. Please complete the following information so that this request may be submitted to our board and staff for approval. Please note that there may be some additional paperwork, payment, and proof of liability insurance needed prior to the event if approved
Name of Group or Organization*
Group or Organization’s Mission or Purpose*
Is Group or Organization a Non Profit? (If Yes please include ID No in the space below.)

YesNo
Non Profit ID No
Person Who is Point of Contact*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Event or Purpose for use of Facility
Event Date and Time*
Event Date

MonthDayYear
Date
Event Time (Start-End, note AM or PM)
Number Attending Event/Meeting:
Is anything needed for use at the facility other than the space? (Ex - tables, chairs, audio and/or visual equipment, etc.)
Name & Signature Or Representative Of Group/Organization Making This Request

Clear
Contact Info (If different from phone number and email given above.)
If you have any further questions contact info@thelivinroomhsv.org.

Thank you again for your interest and support of the ministry of The Livin’ Room.

The Livin’ Room is a 501(c)(3) non-profit organization
Should be Empty: