Building Use Application - First Church in Dedham

Name Of Requesting Group_______________________________________________________________

Name of Applicant______________________________________________________________________

Address______________________________________________________________________________

Phone Number - Home _______________________ Business ___________________________________

Cell ________________________ E-Mail _________________________________________________

Are you a First Church Member? __________________________________________________________

Proposed Date(s) ______________________________________________________________________

Time*_______________________________________________________________________________

Room(s) Needed_______________________________________________________________________

Number Attending______________________________________________________________________

Activity Planned_______________________________________________________________________

PERSON RESPONSIBLE FOR CLEAN-UP _____________________________________________________

(NAME AND PHONE NUMBER)

CUSTODIAN IS NEEDED FOR ALL ACTIVITIES HELD OUTSIDE OF CHURCH OFFICE HOURS (see reverse side for fee)

*All Evening events by non-church groups must conclude by 11p.m. and the building vacated by 11:30 p.m.

See Reverse side for donations for use schedule

Liability Statement

The individual or group requesting to use First Church and Parish in Dedham building(s) is liable for all damages to facilities or equipment that results from this usage. This liability extends to the full cost of restoring the facilities and equipment to full working condition.

The applicant will be responsible for all danger to life and property arriving out of its activities or the acts of its agents or employees in connection with the use of the facilities authorized under this Building Use Application. The applicant agrees to protect, indemnify, and save harmless the First Church and Parish in Dedham, its officers, agents, and employees from and against all claims, demands, causes of action, and liability of any kind arising out of or sustained by virtues of its use of the facilities authorized by this Building Use Application.

Alcoholic beverages are NOT permitted without special negotiation.

Signature of Applicant___________________________________________________________

Name of Applicant______________________________________________________________

Date Submitted_________________________________________________________________

Parish Committee Action

Date_______________________Granted____________________Refused_________________

Conditions____________________________________________________________________

Applicant Notified – Date___________________ BY__________________________________

Donations for Use

Parish House Rooms:

½ day or less	$	150
Full day		300
If cooking add $50
Add second room $50.
Small rooms (4 hours or less)		80

Custodian Fee (minimum 3 hours; make check out to John Reilly)

15/hr.

Meeting House:

Wedding/Memorial Service	400
Custodian Fee	50
Fuel Surcharge (seasonal)	75