Facilities request form

UCUMC - Calendar & Facilites Request Form
You are required to clean up after you event. This includes cleanup of all materials used, cleaning surfaces, and taking out the garbage. You will also be responsible to set-up and reset-up the furniture for this event. Please plan ahead so that you have the neccessary number of volunteers to assist in this. Failure to comply could result in loss of security deposit.
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I understand that the setup and reseting of the room is my responsibility.
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I understand the I am responsible to clean the facility after our event.

UCUMC - Calendar & Facilites Request Form
Event Information
Name of Event*
Event Start Date*

MonthDayYear
Date
Start Time*

:HourMinutesAM/PM Option
Event End Date*

MonthDayYear
Date
End Time*

:HourMinutesAM/PM Option
Please note:

You will be given 30 minutes pre-event and 30 minutes post-event for set-up and clean-up. If more time is needed please contact: dprice@ucumc.org
If this is an ongoing event, please specify start and end dates and frequency.
Event description*

UCUMC - Calendar & Facilites Request Form
Facility Specifics
Specific Room(s) Requested
if unsure, please indicate preferred size and type of room needed.
Expected Attendance*
Do you request the use of the kitchen?*

NoYes, full service (cooking and serving)Yes, serving only (catered event)

UCUMC - Calendar & Facilites Request Form
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 MinistryHold Harmless AgreementCertificate of Liability (email policy directly to dprice@ucumc.org after completing this form)
Be sure that you complete this Facilities Request Form.

Open Hold Harmless Agreement in separate window
Your Name

First NameLast Name
Should be Empty:

UCUMC - Calendar & Facilites Request Form