Facility Use We, the [enter name of persons, group, or organization] (hereinafter called the "User") request permission to use the property of Hillwood Presbyterian Church (hereafter called “Hillwood PC”).*Requested Date* MM slash DD slash YYYY Time of Event : Hours Minutes AM PM AM/PM Space Requested*Please check all being requested and include any furnishings or equipment needed Community Room 1 Community Room 2 Parlor Restrooms Field- enter area in space below Parking Lot- enter # of spaces below Other Field Area RequestedNumber of Parking Spaces neededOther Furnishings/Equipment NeededFrequency One-Time Use On-going If on-going, please enter the requested start dateFor the purpose of*NOTE: • Session approval in advance of the event will be needed for all on-going use of the facility or grounds. One-time use also may require advanced session approval. • User must dispose of all food particles, and garbage/refuse. • If used; wash, dry, and return dishes and utensils to designated storage. • Hillwood PC facilities and property is to be alcohol and smoke-free. Weapons are not permitted onsite. Failure to comply will result in immediate termination of use. • Compliance to all other Hillwood PC property policies is required. THE USER WILL BE FULLY RESPONSIBLE FOR: 1. Leaving the facility and grounds in a clean and orderly condition and returning any furniture or equipment used by same to positions occupied before the facility use 2. Closing and locking the building, turning off all lights (providing that the facility is not otherwise occupied by other groups) 3. Repairing/replacing all damages to church property resulting from the usage herein granted 4. Empty garbage by placing all garbage in the dumpster outside at the back of the property; outdoor use required to remove and take all trash off property with them The following person(s) will be responsible for following church guidelines and cleaning and securing the facility and grounds before leaving:* First Last Email* Phone*Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Preferred method of contact Phone Email Name of Responsible Person 2 First Last PhoneEmail Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Preferred method of contact Phone Email KEYS: For on-going use in the facility only, a key to the facility may be granted to one or both of the Responsible Parties listed above. Please note that a non-refundable key deposit of $100 is required for each key. Keys are the property of Hillwood PC and when issued are to be guarded safely. Loss of a key will result in a non-refundable $150 key replacement fee. At termination of facility use, all keys must be returned within three business days or a non-refundable $150 replacement fee will be charged per key. If new locks are required on doors, the session will determine the amount of a non-refundable key fee – which will be due at time of key re-issuance. If key/s are found to be in the possession of someone other than Person 1 or Person 2 listed above, the church reserves the right to terminate the User’s facility use immediately.Number of Keys RequestedPlease enter a number less than or equal to 2.There will be a total Non-Refundable Key Deposit Due when form has been processed. The church office will contact you with the price.Name of Party/ies to receive key/s (NOTE: only Person 1 or Person 2 listed is eligible for a key): First Last Name First Last INSURANCE:The User does do/does not carry insurance to protect the church from liability for damages to persons or property. (check one below) [Insurance for $1,000,000 minimum liability is required for field or parking lot use and Hillwood Presbyterian Church must be named as additionally insured.]insurance options* Does have Insurance (submit certificate of insurance with Hillwood Presbyterian Church named as additionally insured) Does Not have Insurance (if no insurance, the session will consider if use still can be approved) USE OF SPORTS FIELDS also requires completed waivers of liability from each participant before use. Note that Hillwood Presbyterian Church does not maintain fields to sporting use. Participation is at users’ own risk. (See additional form for each participant to complete and return to Hillwood Presbyterian Church prior to use.) DONATION: A donation to Hillwood PC is requested for non-member use of the facilities. The amount will be negotiated with the church session. On-going field use requires a financial donation or out of pocket cost to maintain.Donation AmountAnticipated Date Donation will be sent MM slash DD slash YYYY Make checks payable to Hillwood Presbyterian Church; mark memo line: Facility Use Donation. To give a donation online, go to www.hillwoodpc.org and click the Give Now button. (Note: a 2% transaction fee will be added to your donation if paying online and the User is responsible for covering this fee in addition to the agreed donation amount listed above.) Indicate the time/frequency of donation: When Permission for Use Granted Weekly Monthly Quarterly REVIEW OF USE: Facility and grounds use will be reviewed after initial 90 days of use and every 6 months thereafter. Details of this agreement may be amended at review. Hillwood PC reserves the right to terminate use at any time and may give the User 30 days’ notice. For on-going use, please note that occasionally ministries of the church (e.g. seasonal worship services, funerals, weddings, etc.) may take precedence over use agreed herein. Every effort will be made to relocate or reschedule User’s use as far in advance as possible.Agreement*By checking this box, you understand the terms and policies set by Hillwood Presbyterian Church regarding their Property Usage. I agree to the terms stated above Δ