Building Use Application

Full Name*

First NameLast Name

Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Email Address*

Phone Number*

Area CodePhone Number

Name of Organization*

ex: Boy Scouts, Mom's Group

Type of Organization*

Date Requested*

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Start Time Requested*

:HourMinutesAM/PM Option

End Time Requested*

:HourMinutesAM/PM Option

Is this a recurring event?

YesNo

Please describe requested recurring dates/frequency of meetings, if applicable.

Description of Event (ex: dance class, Boy Scouts meeting, soccer banquet):

Number of Participants*

Will children be present at the event?

YesNoUnsure

Can you provide proof of liability insurance and add St. George as an additional insured for this event?

YesNoUnsure

Will a member or regular attender of St. George be present for your event? If applicable, please add their name here.

Equipment/Rooms Needed (Check as many as apply):

Please note: use of the sanctuary or buildings for weddings and worship services require additional review by the Vicar. Please email the church directly at SaintGeorgeEpiscopal@gmail.com. Thank you!

I understand that submitting this form online means that I will be contacted about this request, and that building use at Saint George may involve fees, a signed contract and/or other requirements, all to be mutually negotiated at a later date.*

Yes

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