PLC SPACE RENTAL REQUEST FORM

PALISADES LUTHERAN CHURCH REQUEST FOR USE OF SPACE FORM
Today's Date

MonthDayYear
Date
Your Name

First NameLast Name
Church Member
Your Sponsor's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Home Number
Cell Number
Liability Insurance YES NO
Donation or Charge Expected
Type Amount
One Time Request or Multi Date Request

Multi Date Use of Space Request must be renewed annually. The week of Holy Week is not available. All requests must e approved by the Church Council. Church Council meets 2nd Tuesday of most months
DATE OF REQUEST FOR ONE TIME USE

MonthDayYear
Time Slot Requested ex. 7pm to 8pm
MULTI DATE USE REQUEST DAY(S) OF WEEK/MONTH
For Examples Tuesdays 2x's a month ect.
Start Date of Use

MonthDayYear
Date
End Date of Use

MonthDayYear
Date
Time Slot Requested ex. 7pm to 8pm
Pricing, Deposit, Fees, Donations

$150.00 Refundable Deposit to ensure space is left as agreed.

$25.00 A day charge per each parking spot used (parking lot use only).

$95.00 Clean up fee is required if food is served.

(Food and drinks, except for water, are NOT allowed in Sanctuary)

Donation to PLC is requested at 10% of gross receipts or

Donation of $25.00 per hour for events not generating income.

Checks payable to Palisades Lutheran Church
Facilities Requested: (check all that apply)

SanctuaryFireside RoomKitchenRefrigerator SpaceLuther HallTables & ChairsNarthexParking LotPatioPlay YardSanctuaryYouth RoomCourtyard
Acknowledgement

Permission to use space at Palisades Lutheran Church does not imply agreement with any statements made or opinions expressed by any person or group using the space.

I agree to the following terms and conditions with respect to accommodation at Palisades Lutheran Church.

New requests for one-time or ongoing use of space must be made on this Use of Space Request Form obtained from the Church Office at 310-459-2358 or by e-mailing OfficeSecretary@plc.cc.

The needs of the church to use its own space take priority over any other arrangements.

PLC reserves the right to cancel or terminate any arrangement as deemed necessary by the Pastor or Church Council. In such cases any deposit will be refunded.

Only rooms approved for use may be used and must be arranged as agreed.

Any damage to the building, its contents or grounds is the responsibility of the individual or group using the space.

Donation must be made by the day of the event unless other arrangements were made.

Please do not smoke on church property.

In consideration of our neighbors, no non-church activities may go past 10:00 p.m.

Food and drinks, except for water, are not allowed in the sanctuary. NO EXCEPTIONS.

For use of the kitchen you may bring your own food and drinks, dishes and utensils. PLC supplies may not be used. Space for food to be stored in refrigerator must be approved. Stove and oven may be used for warming only. Kitchen must be left clean, all leftover food and trash must be taken home or put in dumpster before leaving.

Sanctuary seats 200, plus 50 in balcony.

PLC does not offer set up or take down of furniture, supplies or decorations. 150 moveable chairs, 12 round and 12 6 ft tables are stored in Luther Hall closet. Approval must be given for use of furniture which must be replaced in closet when event is over.

Luther Hall is not heated in winter. Sanctuary may be heated.

Entrance ONLY on El Medio and Exit ONLY on Sunset.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date

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Date
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PALISADES LUTHERAN CHURCH REQUEST FOR USE OF SPACE FORM

One Time Request or Multi Date Request