Non-Profit Agreement Form

FACILITY AGREEMENT FORM NAME: * ADDRESS: * CITY: * STATE: * MissouriAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowakansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMissisippiMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP: * PHONE: * FAX: EMAIL: EVENT: * NUMBER OF GUESTS: * START DATE: * END DATE: * SETUP TIME: * SETUP FINISH: * Room(s) Requested: * Worship CenterApexKitchen (in Apex)Warehouse HangarClassroomGarageDrive-InStudio 34 Kitchen (in Children’s Building)Café 56Indoor PlaygroundConference Room (in Children’s Building) Setup Options: * Theatre – Chairs onlyRound tables w/chairs8’ tables w/chairsHollow SquareOne table together w/chairsTwo tables together w/chairsU-shaped with chairs Additional setup notes: Technical Needs: (Explain in detail below) BAND: DrumsBassAcoustic GuitarElectric GuitarKeyboard/PianoSynthVocalists SPEAKERS: MaleFemaleWired Mic On StandWireless Mic- Number RECORD EVENT? AUDIO: YesNo VIDEO: YesNo TECH INFO... WORD ON SCREEN: YesNo Play CD: YesNo Play DVD: YesNo Play VCR: YesNo PowerPoint: YesNo PRO-PRESENTER: YesNo IMAG: YesNo LIGHTS: Single SceneMulti Scene NOTES: Name of Person to be Contacted Regarding Technical Needs: Terms: We agree to the following Facility Use Regulations: 1. Abide by the established policies and guidelines as set forth in this packet. 2. Reimburse FBC for any damage to church property and claims of liability. 3. As applicable, provide a certificate of insurance with bodily injury and property damage limits of at least $1,000,000 and naming FBC as an additional insured. 4. 50% of estimated fees are due with the submission of this request. 5. The balance plus a $25 refundable cleaning deposit are required seven (7) days before the event or it may be removed from the calendar. Separate Checks are required. 6. Those using FBC facilities agree to release, protect, defend, indemnify and hold harmless FBC and its trustees, officers, employees, members and other representatives from and against any and all claims, liabilities, losses, damages, actions, costs and expenses (including, without limitation, reasonable attorney’s fees and other legal costs) directly or indirectly arising out of their use of any FBC facilities. I hereby agree to all terms made within this agreement. Iif any changes take place it is my responsibility to inform all concerned parties. * I agree