SHADY GROVE UNITED METHODIST CHURCH BUILDING USE AGREEMENT

, REPRESENTING requests permission to use the appropriate facilities of Shady Grove UMC, the approximate number of participants being for the following purpose . I am responsible for my own set up and take down for any weekend programs (Friday-Sunday). Custodial assistance may be available during weekdays on a limited basis. Contact the church office at 746-9073 to make arrangements for custodial assistance. I acknowledge having read and understood the indicated rules and guidelines and agree to accept the facilities of Shady Grove UMC as they are and be bound by the aforesaid rules and guidelines. It is likewise agreed that we shall be solely responsible for any injury to persons or damage to property that results or occurs during our use of said facility. We further covenant to save harmless Shady Grove UMC from any damage or liability resulting wherefrom.

Signature:______Date ------(Please print legibly) Contact Person: E-mail Address: Organization’s Address: Phone: Office Number: Secondary Number: For (Organization): Church Group: Outside Group: Set Up Time: Program Date(s): Program Time: Is this the first time this person/group has used facility? If no, date and time of previous use: Do you have liability insurance?

LOCATION: Wade Gym: Gym (G-120) Nurseries Classrooms Elective Room (G-110) G-102 (Nursery I) G-114 Kitchen (G-112) G-104 (Toddlers) G-201 Multi-Purpose Room G-106 (Nursery II) G-202 G-111 G-204 G-113 Stage G-206 Youth Rooms Shelter G-207 G-213 Vesper Area G-210 G-215 Playground G-212 G-217 G-218 G-220

SPECIFIC NEEDS: (Please note: outside groups must supply their own audio-visual equipment.) Chairs: # Tables: # AC/Heat Showers Other

Supervisors: Name Gym Name Kitchen Name

If you have questions, please contact Cindy Spieth in the church office, 746-9073.

Guidelines Required: Responsibilities in the Use of Facilities Guidelines for Chaperons Job Description for Gym Supervisor DJ Guidelines Guidelines for Use of Kitchen Responsibilities of Person with Keys Dance Guidelines