HC Facility Use Request Form

Please read through the HC Facility Use Policy BEFORE completing this form!

Your name *

Email address *

Phone number *

Today's Date *

Name of Individual (if different from person completing form) / Group / Organization Requesting Use

Brief description of group/organization function and purpose *

Name of Contact Person (if different from person completing form)

Email of Contact Person (if different from person completing form)

Phone Number of Contact Person (if different from person completing form)

Frequency of Use *

Date(s) Requested for Use *

Arrival Time *

Time of Event *

Departure Time *

Space Requested

Narthex/Lobby

Fellowship Hall

Kitchen

Other

Number of People Attending *

Acknowledgement (Please read and type your name below) *

By completing this form, and typing your name below, the requesting person/group/organization acknowledges that Holy Cross Lutheran Church will not be liable for any thefts, injuries, or damages resulting from or arising out of the use of the facility, and further agrees to indemnify and hold Holy Cross Lutheran Church harmless for any such liability. Failure to comply with the Facility Use Handbook policy can result in denial of further use of Holy Cross facilities.

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