Request and Agreement Form

Church Facility Reservation Request and Agreement Form

* Indicates required field

Name of person or organization requesting use of facilities *

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Last

Address *

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City

State

Zip Code

Country

Phone Number *

Email *

Please select the option that best describes the person or organization requesting use of facilities: *

Church Member Church-Sponsored Ministry Non-Member Non-Member Group/Organization

What date(s) and time(s) are you requesting to use the facilities *

Please describe which church facilities you are requesting use of and the purpose for which you intend to use the facilities: *

If the requested use is by an organization not affiliated with the church: *

*All information in this section is required if you are requesting use of our facilities for an organization not affiliated with the church

Please briefly state the organization's purpose and mission: *

Please list the names and titles of the organization's office-holders and leaders *

Please list the organization's website, if any: *

If the requested use is for a wedding and/or wedding reception: *

*All information in this section is required if you are requesting use of our facilities for a wedding and/or wedding reception

Name of bride: *

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Last

Name of groom: *

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Last

Contact information for bride: *

Contact Information for Groom: *

Name of person officiating the wedding: *

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Last

Religious affiliation of person officiating the wedding: *

Contact information for person officiating the wedding: *

Please describe the marriage preparation counseling or training undertaken by the bride and groom: *

Additional Questions or Comments: *

Church Facility Use Agreement

I have read and will uphold the Furnace Brook Wesleyan Church Facility Use Policy and affirm that:

I understand that the church does not allow its facilities to be used in a way that contradicts its faith or by persons or groups holding beliefs that contradict the church's faith.
To the best of my knowledge the purpose for which I am requesting use of the church facilities will not contradict the church's faith, and I commit to promptly disclose any potential conflict of which I am aware or become aware to church staff.
I am not aware of any beliefs that are professed by me or the organization I represent and which is requesting use of the church's facilities that contradict the beliefs of the church. I agree to promptly disclose any potential conflicts in belief to church staff.
I understand that upon approval of my facilities use request, I will need to provide a security deposit in the agreed-upon amount, and any other fees required by the church.
I understand that the church does not allow its facilities to be generally available to the public, and that my use of these facilities is subject to the pastor's approval, which is conditioned in part on my agreement to the requirements in the "Church Facility Use Policy," a copy of which I have read and understood.
I understand that I will be responsible for any damages to the church facilities resulting from this proposed use of facilities.
The church believes disputes are to be worked out between parties without recourse to the courts. See, generally, Matthew Chapter 18 and 1 Corinthians Chapter 6. Accordingly, users of the facility agree to attempt resolution of any disputes through Christian mediation.

Name *

First

Last

Date *

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