Facility Use Request Form

This form is to request rental of a room or rooms in the Alive In Christ building (e.g. Fellowship Hall) for private use. Please note that we typically do not rent the sanctuary; and we typically do not rent any part of the building during Advent or Lent. Before filling out this form, we encourage you to reach out to us at aicoffice@aic.org or 573-499-0443 to find out if the dates you are needing are available.

Your name *

Email address *

Is the person requesting use of the Alive In Christ (AIC) facility a member of Alive In Christ? *

You must be an AIC member to rent space.

Name of the member who will be responsible for the event?

Will the member above be present at the event?

What is this request for?

Please note that there is a $50 rental fee for individual events and $200 for group/organization events.

Individual/family event (e.g. birthday party, baby shower, reunion, etc)

Organization event that I am a member of

Other

Address

Phone #

Date of Event *

Please note - we do not rent any part of the facility more than 6 months in advance of the event in order to avoid interference with potential church ministry events.

Start time of event

End time of event

Check all that are required for this event

Thermostat adjustment requested (if other than normal temperature range)

Building access requested

Computer/Projector/Smart TV

Sound system

If building access requested, do you already have a building access?

Do you have a key or keycard?

Facility needs(please check all of the rooms requested)

Fellowship Hall

Kitchen &/or Serving Room

Room 8 (Youth Room; with computer & projector)

Room 9 (Youth Room; with computer & projector)

Room 11 (Couch Room)

Room 12 (Classroom with smart tv)

Children's Classroom(s)

Table(s)/Chair(s)

Other

Special room arrangement or equipment requested:

User provided equipment (listed above or other)

A/V technician support requested

Please note that there may be an additional charge for this AND we can not guarantee that availability of a tech.

Estimate number of people attending:

Please explain the activity to be held: *

Waiver & Electronic Signature

Waiver & Electronic Signature - (Typing name below indicates agreement with above statement). *

Applicant hereby agrees to hold Alive in Christ Lutheran Church, its governing board, the individual members thereof, and all its officers, agents and employees (“Releases”) free and harmless from any loss, damage liability, personal injury, cost or expense during or be caused in any way by such use of occupancy of Alive in Christ Lutheran Church property whether caused in whole or in part by the negligence of the Releases. I further agree that if, despite this release and waiver of liability, anyone makes a claim against any of the Releases, I will indemnify and hold harmless each of the Releases from any loss, liability, damage, or cost, which any may incur as the result of such claim.

All applications shall bear the signature of a person 21 years or older who is the person or duly authorized representative of the organization or group making the request.
I HAVE READ AND UNDERSTAND THE POLICIES ATTENDANT TO MY RENTAL OF THIS FACILITY, INCLUDING THE RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, AND I AGREE TO ABIDE BY THEM.

Today's Date *

For Office Use Only

Space Utilized

Board of Directors Approval Required?

Permit/Certificate Submitted?

If required.

Approved by:

Please include signature, printed name & date

A copy of your responses will be sent to your email address.