Building Use Form

Holy Trinity Lutheran Church Building Use Agreement Form
ALL BUILDING USE REQUESTORS, INCLUDING RENEWALS, MUST FILL OUT THIS FORM.

IF YOU ARE UPDATING YOUR CURRENT USE REQUEST (SUCH AS THE IMPLEMENTATION OF SIGNS), YOU MUST RE-SUBMIT THIS FORM.

PLEASE NOTE FOR NEW OR ALTERED REQUESTS, INCLUDING WEDDINGS, SUBMISSION OF THIS FORM IS NOT AN AUTOMATIC APPROVAL. THEY REQUIRE APPROVAL FROM THE APPROPRIATE AUTHORIZED PERSONS OF HOLY TRINITY.

REQUESTS MADE AFTER THE THIRD WEDNESDAY OF A MONTH, MUST WAIT UNTIL THE FOLLOWING COUNCIL MEETING.

CLICK THE "NEXT" BUTTON TO BEGIN THE FORM.

[SUBJECT TO PROPERTY COMMITTEE REVIEW AND HTLC COUNCIL APPROVAL BEFORE any items may be stored on premise]

Please provide a detailed description of (1) the item(s) to be stored (2) the approximate number of square feet required for storage and (3) plan for securing, below.

IF YOU DO NOT REQUIRE ITEMS TO BE STORED AT THE CHURCH, CONTINUE TO UPLOADING YOUR PROOF OF INSURANCE.
1 - Item(s) to be stored
2 - Square Feet Required for Storage
3 - Plan for Securing

Please Upload Your Proof of Insurance (REQUIRED OF ALL ORGANIZATIONS)

Certificate of Insurance
Cancelof
Is any food to be stored on site? If approved all food must be stored properly in sealed containers so as not attract vermin. No out-of-date food products will be permitted for storage. Any spoiled or open products that are not contained will be removed by the property committee or assignee at the risk and expense of the tenant and cleaning and pest services charges may also apply.
If On-Site Storage is approved:

THE TENANT USING THE BUILDING IS RESPONSIBLE FOR SECURING THEIR PROPERTY AT THEIR OWN EXPENSE AND HTLC, ITS STAFF, CONGREGANTS, AND VISITORS WILL HAVE NO RESPONSIBILITY OR LIABILITY FOR LOSS OR DAMAGE OF TENANT STORED ITEMS REGARDLESS OF CAUSE. STORAGE ON- SITE IS THE SOLE RESPONSIBILTY AND LIABIILTY OF THE OWNER OF THE ITME(S) BEING STORED. PROOF OF INSURANCE IS REQUIRED.

Storage of items shall not impair the ability of church function, or emergency ingress or egress to, from, or within the building. Failure to abide by the above may lead to the immediate termination of a previously approved storage clause and the removal of items(s) at the risk and expense of the tenant.

Proof of Insurance: Required for any group hosting an activity beyond a one-time (e.g., single event or day - like a wedding or birthday party) basis and must include any property that has been approved for storage. Examples include: sporting camps, scout troops, group or association weekly or monthly meetings, etc. Proof of insurance must be attached to this form. For existing tenants, current proof of insurance must be provided within 30 days of signing an update agreement, and must be kept current. This will be reviewed on an annual basis.

Sole Use Exclusion: HTLC staff including, pastor, administrator, council leadership, property committee, and assignees reserve the right to be on premises at all times. No tenant shall have sole or exclusive access to the property at any time.
The undersigned certifies that he/she has been provided and accepts the Holy Trinity Lutheran Church Building Guidelines and Policies document (see below). The undersigned assumes full responsibility for all damages to Church property caused by said use and undersigned remits a security deposit (if applicable) in the amount to be determined. All or any part of the deposit not required for cleanup or repair will be refunded. For Weddings and/or Receptions, $250 is due with this application, the balance is due by the day of the wedding. This amount does not include the fee of the Pastor, the organist, or the custodian. You must contract with them separately. Please make checks out to Holy Trinity Lutheran Church.
Applicant's Signature*

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Applicant's Name*

First NameLast Name
Group or Organization
Address*

Street Address

Street Address Line 2

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Postal / Zip Code
Personal Phone Number*
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Personal Phone number a landline or cell?*

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Secondary Personal Phone Number
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Secondary Personal Phone number a landline or cell?

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Work Phone Number
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Work Phone number able to receive texts?

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Email Address*
example@example.com

INDEMNIFICATION AGREEMENT
In consideration of the Holy Trinity Lutheran Church, Leesburg, Virginia, granting to the undersigned* the privilege to use certain facilities of Holy Trinity Lutheran Church, the undersigned, if more than ONE, jointly and severally, hereby agree to indemnify and save harmless Holy Trinity Lutheran Church and all members and employees thereof from any and all claims, causes of action, demands, suits, or actions at law and in equity for any loss or personal injury suffered or received by any person arising out of or occurring during the use of any facilities owned or maintained by Holy Trinity Lutheran Church in connection with the use of said facilities. In the event of any claim being asserted, Holy Trinity Lutheran Church agrees to give to the undersigned written notice thereof as soon after such claim is asserted as is reasonably practical.
- Fellowship Hall (the Hall) Capacity: 75 attendees
- Equipment and Décor: Any Tenant who needs decorations/equipment ("Personal Property") for the Event, is responsible for bringing all such items into the Hall and immediately removing all Personal Property from the Church upon the completion of the event. The Church is not liable for any damage to the Tenant's Personal Property.
- The Tenant may, with the prior written consent of the Church, rent chairs, tables or other equipment other than those already present in the Hall for the Event. The Tenant shall be solely responsible for use of any such third-party rentals and shall promptly remove any such additional chairs, tables or other equipment at the end of the Rental Period unless other arrangements have been made with the Church.
- The only decorations permitted in the Hall are those which may be placed on the floor, on the walls or on the tables. Scotch tape, nails, tacks or staples are not permitted to be used for any decorating purposes on walls, tables, ceiling tiles, grid work or wood work. Only removable masking or decorating tape may be used for decorating. The Tenant shall not hang, tape or suspend decorations from the walls or ceilings of the Hall unless authorized by the Church. It shall be Tenant's responsibility to promptly remove all decorations upon conclusion of the Event.
- The use of any dancing powders, glitter, fireworks or sparklers is prohibited. No heavy items causing marring or scratching are permitted to be dragged across the floor. No stages may be set up in the Hall. All balloons must be securely fastened, no free-floating balloons in or out of Hall.
CANCELLATIONS
- Tenant acknowledges that if it cancels or otherwise abandons its planned use of the Hall prior to the time of the Event, this action constitutes a breach of Tenant's obligation to the Church, and the Church is harmed. In the event of cancellation by the Tenant prior to the Event, the rental deposit ($250) minus $100.00 liquidated damages will be returned, but only if the Hall is re-rented for that particular day. If the Hall is not re-rented for that day, then the whole rental deposit ($250) will be forfeited as liquidated damages. Provided that Tenant pays such liquidated damages, the Church agrees not to seek additional damages from Tenant relating to the Cancellation.
- The Church shall undertake all reasonable efforts to re-rent the Hall. Should the Church re-rent the Hall, the Church will refund the rental deposit less the liquidated damages ($100) within seven (7) days after the event date.
- To avoid all doubt, this liquidated damages provision pertains only to cancellation by the Tenant prior to the Event. If the Tenant breaches this Agreement by violating any restrictions during the event, the Tenant is liable for actual damages notwithstanding this provision.
- In the event of cancellation by the Church, a full refund will be issued to the Tenant.
FORCE MAJEURE
- The performance of this Agreement by either party is excused if it is prevented or prohibited by any event outside that party's control, including, but not limited to, Acts of God, war, terrorism, government regulation, natural disaster, fire, storm, earthquake, flood, labor disputes or strikes, civil disorder, epidemics. This Agreement may be terminated for any one or more of such reasons by written notice from one party to the other. Should a Force Majeure event occur and Tenant be forced to cancel the Event, all deposits and monies received to date by Church will be refunded in full to Tenant at the time of cancellation, notwithstanding paragraph 10 above.
- If a Force Majeure event occurs, neither party shall be liable to the other for any regular or special, indirect, incidental, consequential, punitive or exemplary damages, including, but not limited to, lost profits, even if such party has knowledge of the possibility of such damages.
COMPLIANCE WITH LAW
- This Agreement is subject to all applicable federal, state and local laws, including health and safety codes, alcoholic beverage control laws, disability laws, federal anti-terrorism laws and regulations, and zoning variances. Church and Tenant agree to cooperate with each other to ensure compliance with such laws.
- The Tenant shall at all times comply with all applicable laws and regulations and shall not use or occupy the Hall for any unlawful purpose or permit others to use or occupy the Hall for any unlawful purpose.
CHOICE OF LAW

This Agreement shall be governed and interpreted in accordance with the law of the Commonwealth of Virginia without reference to the conflict of laws, provisions of that state. Only the federal and Virginia State courts in Loudoun County, VA shall have jurisdiction over this Agreement and any controversies arising out of this Agreement. The parties hereto hereby submit to the jurisdiction and venue of such courts.
LITIGATION EXPENSES

The parties agree that, in the event litigation relating to this Agreement or the event is filed by either party, the non- prevailing party in such litigation will pay the prevailing party's costs resulting from the litigation, including reasonable attorneys' fees.
CONSEQUENCES FOR NON-PAYMENT:

Failure to pay in good faith for the privilege of use of the building may result in no future use of the building for events without pre-payment in full, an may further result in litigation expenses as described above to recover any monetary loss of the Church.
Signature*

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Date*

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INDEMNIFICATION AGREEMENT