Piedmont Triad Church Facility Use Application

Person Making Request

First Name

Last Name

Phone

Which Area(s) Will Be Needed

Check all that apply

Auditorium
Kitchen
Patio
Middle School room
Babies room
Other children's ministry rooms
Lobby
Entire facility

Date

Estimated Start Time

HOUR

MINUTE

AM/PM

Estimated End Time

HOUR

MINUTE

AM/PM

Type/Purpose of Event/Activity

For use of the Audio/Visual in the Building -Please fill out the AV form

Other Requests:

Liability Statement

I, the undersigned, agree to abide by the use and maintenance policies of the Piedmont Triad Church facilities. I agree that I am responsible for any liability claims and negligence resulting from the above named activity/event, and I agree to indemnify and hold harmless the Church and any of its members, employees, directors, and officers for any attorney fees, damages, monetary, or otherwise, expenses, or other amounts paid in connection with any legal proceeding in which the church or any other such named person becomes involved by reason of this use agreement.

Signature

To accept this contract, type your name below

Date

We will be in contact shortly regarding your application.

Please Note: If you need to change or cancel your reservation, please notify admin@triadchurch.org as soon as possible. To allow others to book the facility.

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Piedmont Triad Church Facility Use Application

Thank you for contacting us!