CLC Event Initial Request Form

Calvary Lutheran Church encourages and supports Christian oriented functions that reflect the vision of our church, and provide educational experiences designed to foster strong Christian leadership.

1. Name of Event *
2. Event Date *
3a. Set-Up Start Time 3a. Set-Up Start Time * : HH MM AM/PM
3b. Tear Down End Time 3b. Tear Down End Time * : HH MM AM/PM
4a. Event Start Time 4a. Event Start Time * : HH MM AM/PM
4b. Event End Time 4b. Event End Time * : HH MM AM/PM

5. Event Needs... *
5. Event Needs...	Yes	No
Sound System	Sound SystemYes	Sound SystemNo
Sanctuary $300	Sanctuary $300Yes	Sanctuary $300No
Classroom $50	Classroom $50Yes	Classroom $50No
Dakota Room $50	Dakota Room $50Yes	Dakota Room $50No
Kitchen $100 (Preparing food @ CLC)	Kitchen $100 (Preparing food @ CLC)Yes	Kitchen $100 (Preparing food @ CLC)No
Fellowship Hall ($100/Member and $300/Non Member)	Fellowship Hall ($100/Member and $300/Non Member)Yes	Fellowship Hall ($100/Member and $300/Non Member)No

(There is a $200 security deposit for damages and cleanup. This is refundable, IF the spaces used are left in good order.)
6. Number of People Attending
*
7. Contact Person (from the requesting organization) 7. Contact Person (from the requesting organization) * First Last
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Primary Contract Phone Primary Contract Phone * - ### - ### ####
8. E-mail *
9. Draw your signature into the box below. *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
10. Today's Date 10. Today's Date / MM / DD YYYY
Any and all damages to church property in regard to the event scheduled above will be the responsibility (responsibility is the replacement or repair of the damage) of the person or organization scheduling the event.
The cost of snow removal for lot and sidewalks is the renting event’s responsibility. For safety sake, Calvary will determine when this is necessary.

Church Contact Number: 605-342-9043

CLC Event Initial Request Form

CLC Event Initial Request Form

(There is a $200 security deposit for damages and cleanup. This is refundable, IF the spaces used are left in good order.)