Facility Use Request/Permit

Person/group requesting use:    FPC member: Yes No
Church sponsored program/event: Yes No
Community use: Yes No     Individual use: Yes No
Activity/Event name:
Community users - name of organization:
Non-profit organization: Yes No   (Please provide 501C non-profit tax form if not currently on file with us)
Estimated number of attendees: Adults Youth
Frequency of use: Once Weekly Monthly Other
Explain other frequency:
Date(s) of use:
Activity/event begins: AM PM (including setup)
Activity/event ends: AM PM (including clean-up)
Building/rooms requested:
Koinonia Hall Sanctuary Christian Ed Wing Discovery Room Fireside Room
Agape Conf Rm Kitchen Nursery Courtyard
Any special requirements (i.e. chairs, tables, piano, audio/sound):
Name of person in charge:
Address:
Phone: email:

Please read the following before clicking the Submit Button at the bottom of the page.

General rules

The “Facility Use Request” form must be filled out and submitted.
Written proof of insurance coverage must be turned into the office at least two weeks prior to the date of use.
All use fee deposits and cleaning deposits must be paid prior to the first usage.
No smoking in Church buildings.
No alcoholic beverages are allowed unless insurance coverage is in place.
Room(s)/building(s) to be left neat and clean, and all garbage must be taken to the dumpster.
Food must not be left in the refrigerators.
Prior permission is needed before the fireplace can be used.
All windows and doors should be left closed and locked.
Bathrooms are to left neat; lights should be turned off; and the doors locked.

Proof of insurance

All outside groups or individuals using our facilities are required to provide evidence of liability insurance in the amount of $1,000,000. A certificate of insurance naming the First Presbyterian Church, Petaluma as an additional insured and specifying the activity date and the location shall be provided to the church office at least two weeks prior to the scheduled usage.

The undersigned is authorized to sign this agreement on behalf of the user organization or individual user and agrees to all of the above.

Top