COMMUNITY CHURCH
Saturday, December 14, 2019
An Ecumenical and Inclusive Fellowship of the United Methodist Church
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Application for Facility Use
Community Church at Ocean Pines
a United Methodist Church
11227 Racetrack Road, Berlin, Md. 21811 Telephone: 410-641-5433 e-mail: communitychurch@ccaop.org
Fax: 410-641-5433
Application for Facility Use
A
ctivity Information
Activity: _______________________________________________________________________________________________________________
Facility Requested: ______________________________________________________________________________________________________
WILL THIS USE BE?
OneTime Event Date of Event: _________________________ Start Time: ____________ End Time: ____________________
Ongoing : Start Date: _____________________ End Date: ____________________ Day(s) of Week: _____________________
Start Time: _____________________ End Time: ____________________
Number of People Expected: _________________
Number of Tables Needed: ___________________ (Tables will seat up to 8 persons per table)
Number of Chairs Needed: ___________________
*Special Equipment / Requirements Requested: _________________________________________________________________________________ __________________________________________________________________________________________________________________________
*Setup and take-down by staff is available at additional fee (see Guidelines), otherwise it is the responsibility of the user.
Group Information
Organization Name: ___________________________________________________________________________________________
Responsible Party: ____________________________________________________________________________________________
Address: _____________________________________________________________________________________________________
Telephone: _____________________________ E-Mail: _____________________________________________________________
Contact Person for Group (if other than Responsible Party): __________________________________________________________
Address:______________________________________________________________________________________________________
Telephone: _____________________________ E-Mail: _____________________________________________________________
Check All that Apply
Church Member/Organization
Not a Church Member
Ocean Pines Community Organization
Non-Profit Organization
For Profit Organization
Agreement:
I have read the conditions outlined in the
"Facility Users Guidelines"
Form available in the church office upon request and agree to abide by same, and to make every effort to insure our guest do likewise, if we are permitted the use of these facilities.
Signature: _____________________________________________ Date: _________________________
For Use by Church Office:
A Certificate of Liability Insurance Form is Required:
Yes
No If Yes, Date Form Received: ______________________
Request Approved by Office
Activity Placed on Calendar by: ________________________ Date: _______________________
Request Approved by Board of Trustees:
Yes
No Date; ______________________________________________________________
Key/Code Required (ongoing usage)
Yes
No If Yes, key deposit ($50.00) paid. Date: ______________________________
Total Fee: $_____________ Deposit: $___________________ Date: _________________
Balance Due: $______________ Date: ______________________