Facility Use Request 2019

Application and Approval Form for Use of CUMC Facilities

To be completed for all requests for use of Calvary spaces. Submission of this form is not automatic approval. You will be contacted within 10 business days regarding this submission. As a general guideline, requests received more than 90 days in advance of the requested date will only receive conditional approval pending the needs of Calvary and its ministries.
Please Download Room Rates and Facility Rules Here

Please Download Safe Sanctuary Policy Here
Date of Application

MonthDayYear
Date
Name of Group or Individual
Name
Type/Name of Event
Facility Requested
Notes about room, if needed.
Date of use

MonthDayYear
Date
Time From

:HourMinutesAM/PM Option
Time To

:HourMinutesAM/PM Option
For Ongoing Events: Ongoing users will be requested to carry liability insurance with CUMC as the certificate holder. A certificate must be supplied to the church and reviewed anually. Record dates below for ongoing events.
Ongoing Event From (Date)
Ongoing Event To (Date)
Notes about dates, if needed
Estimated attendance
Total Number attending
Check age level for attendees (Check all that apply)

Children 0-12Youth 13-18Adult 18+Intergenerational
All activities involving children must comply with the CUMC’s Safe Sanctuary Policy. See Link above.
Equipment Requested
TV/AV

YesNo
Tables

YesNo
Number of Tables
Chairs

YesNo
Number of Chairs
Notes about Equipment, if needed
Trustees will reach out to discuss suggested donation for building use based on current Facility Use guidelines.
After approval is granted, send check payable to Calvary United Methodist Church, 403 S. Main Street, Mt. Airy, MD 21771. Full payment of all fees should be submitted 10 days prior to your event (for ongoing use, check needs to be received by the end of each month). References may be requested. *Security deposit will be returned one week following the event if all is in order. If there is any damage or if additional cleaning is needed, these charges will be deducted.
The undersigned agrees to abide by the conditions and rules set forth in the Rules and Information for Use of CUMC facilities. The undersigned will assume responsibility for damage, loss, or other liability arising from the use or misuse of the facilities. If problems or conflicts occur, CUMC reserves the right to limit or terminate the use privileges of the above named group or individuals.
Name of Responsible Person

First NameLast Name
Date

MonthDayYear
Date
Position in Group
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number (Home)

Area CodePhone Number
Phone Number (Office/Cell)

Area CodePhone Number
Email
example@example.com
Name of Designated Alternate Responsible Person (if needed)

First NameLast Name
Address of Designated Alternate Responsible Person (if needed)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number of Designated Responsible Person (if needed)

Area CodePhone Number
Email of Designated Responsible Person (if needed)
example@example.com
I understand by submitting this form that I am not automatically approved for the use of the facility

YesNo
I have read and agree to abide by Facility Rules

YesNo
Should be Empty:

Application and Approval Form for Use of CUMC Facilities