Facility Request Form

Please visit https://www.tscoc.com/engage-pages/community-services for any building use related questions, or call 252-338-2248 and speak to Jonathan Snoots.

Your name *

Last name

Email address *

Phone number

Phone type

Date Needed *

What time do you need the facility? *

Please include setting up and cleaning up time.

Which area(s) of the building do you need? *

Please check all that apply.

Kitchen

Gym

Children's Wing

Upstairs

Lobby

Liability Agreement *

I understand that the building is primarily for church-related functions and that is set up on a first-come, first-use basis whenever possible. Every effort will be made by the Executive Minister to make sure that no such conflicts occur. However, I understand that there is always a possibility that church ministry needs, including but not limited to a funeral, could preclude my use of the building. I, Proposed User, hereby hold TSCOC and its agents, employees, and volunteers harmless against any and all liability, loss, damages, costs and expenses, arising from the use of the Church Facilities by the agents, employees, independent contractors, guests, permittees and invitees of the Proposed User.

Yes

Insurance Agreement *

I understand that I, "Proposed User" may have to obtain a policy of commercial general liability insurance in an amount not less than a combined single limit per occurrence (bodily injury and property damage) of One Million Dollars ($1,000,000.00) and a Two Million Dollar ($2,000,000.00) aggregate limit. The policy shall name Towne South Church of Christ as an additional insured on the User's commercial general liability/property damage insurance policy. Should the User not have commercial general liability/property damage insurance, an event insurance policy should be purchased in equivalent amounts. This is handled on a case by case basis. *

Yes

Cleaning Agreement *

I understand that I am responsible for all clean-up of the building (areas that were used) to the satisfaction of the Executive Minister. After use, the building will be inspected by the Event Director or his designee to inspect the building. I understand that if the building is not cleaned to the satisfaction of the Executive Minister, a cleaning fee of $250.00 will be charged. *

Yes

I have read and understand the fee schedule that is posted on our website. *

Please visit https://www.tscoc.com/engage-pages/community-services under "Building Use"

Yes

I represent and warrant that I am an authorized signer on behalf of the Proposed User with authority to bind the Proposed User. I hereby agree that TSCOC need not inquire further and may rely on my representation of authority. *

Yes

I have read and agree to the terms of the “Building Use Policy”. By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature. *

Towne South Church of Christ
info@tscoc.com
(252) 338-2248