GENERAL FACILITY USE REQUEST FORM

First Name *

Last Name *

Mailing Address *

Mailing City *

Mailing State *

Mailing Zip Code *

Email Address *

Mobile Number *

Cost Breakdown:

*$15 per hour for CAC family (The total amount of hours includes the time needed for setup and teardown.)
*$25 per hour for community (The total amount of hours includes the time needed for setup and teardown.)
*$200 deposit will be required once the event is approved to reserve the facility

Deposit Acknowledgement *

I understand that a $200 deposit will be required to reserve the facility, once the event is approved.

Tip: Please check the box, acknowledging the deposit requirement.

What type of event are you having? *

Description of the Event. Please be as detailed as possible. *

Dates Requested. We recommend submitting up to three possible dates and listing them in order of preference. *

Number of People Expected at the Event: (An estimate number is helpful) *

Time of the Actual Event: * For example: Birthday Party 11 a.m.-1 p.m. *

SETUP Start Time: * What time do you want to begin setting up? (The building will be unlocked 30 minutes prior to the time listed.) *

TEARDOWN End Time: * What time will you finish with cleanup? (The building will be locked 30 minutes after the time listed.) *

I want to view the facility beforehand and am willing to meet with someone at the building during office hours. * Office hours are Monday-Thursday, 9am-4pm or by appointment. *

Rooms Needed for Usage: *

We have chairs, round tables, and/or rectangular tables that you can use for your event. We will show you where they are located before the event for your use to set up and tear down. *

Do you need use of the Sound/Video System? * A CAC-approved sound/video team would operate the system for a fee determined by the length of the event. *

Is there anything else we need to be aware of for this event/activity?

Cleaning Responsibilities *

I understand that I am responsible for cleaning up after the event. This includes, but is not limited to: taking all trash out to the dumpster on the east side of the building; removing all decorations and personal property from all rooms used in the facility; returning all rooms to their original arrangement; leaving the kitchen clean, with everything put away and placing used kitchen linens in the hamper under the sink.

I understand that Cornerstone Alliance Church will provide a clean facility and will provide general post-event cleaning such as, but not limited to: cleaning of the bathrooms, vacuuming all rooms used; mopping the kitchen.

Tip: Please check both boxes, acknowledging cleaning responsibilities. There will be a checkout page must be completed as the end of your usage.

Cornerstone Alliance Church's desire as a Christ-centered, community-focused family is to make our facility available as a shared space. *

I understand that Cornerstone Alliance Church has the right to refuse usage of the facility if it is not in alignment with our Mission/Core Values and/or our Statement of Faith.

I understand that Cornerstone Alliance Church prohibits the use or presence of any drugs, alcohol and/or firearms on the premises.

Tip: Please check the boxes, acknowledging Cornerstone Alliance Church's Right of Refusal and Prohibited Substances

For Use After Event Approval

For Office Use Only

Tip: List any changes to original event request.

Signatures will be required once event is approved.

Renter's Signature ___________________________________________________________________

Cornerstone's Signature ______________________________________________________________

Payments

Full Amount Owed:______________________________________________________

Must be paid in full by:__________________/________________/_________________

Deposit Date:

Balance: __________________________________

Amount:

Payment Date

Balance: __________________________________

Amount:

Payment Date

Balance: __________________________________

Amount:

Payment Date

Balance: __________________________________

Amount: