PMBC Usage Form PRAY'S MILL BAPTIST CHURCH USAGE REQUEST FORM Name* First Last Phone*Type of Activity* Date* MM slash DD slash YYYY Time (from setup to cleanup)* Select the requested rooms, equipment, vehicles:* Sanctuary Table in Foyer Parking Lot (front or back) Office Kitchen Children's Bldg (incl Nursery) Fellowship Hall (old - near kitchen) Fellowship Hall (new - near restrooms) Gym Gym Kitchen Children's Playground Bus Barn Grill Van / Bus Sunday School Room Sunday or Wednesday activities (including setup and cleanup) cannot cross over worship service times. Regularly scheduled activities adn other church-wide activities have prior claim to the use of the sanctuary & FLC. No events, activities (including setup / cleanup) may be used during regular worship service times. All groups using any campus facility, grill, and vehicle are responsible for the setup, clean-up, arrangement of equipment (chairs, tables, etc.) and refilling vehicles. This request form along with the checklist must be completely filled out by the person responsible for the activity. No use of the facilities will be granted unless this form is filled out and approved. You are NOT ALLOWED TO USE anything in the pantry of the gym kitchen unless given permission. All trash must be emptied into the dumpster and a new trash liner must be put into the trash can. No skateboards, roller skates, scooters, or any other toy made for outdoor use will be allowed in the gym. Please note that we use video cameras on the facilities of Pray's Mill Baptist Church. Keys: I understand that I must arrange to pick-up and return the key or keys during church business hours (Mon. - Thurs. 7:30am - 4:30pm). Please do not request keys during worship times. I understand that I/we are limited to the requests made on this form only. I further understand that IU am responsible for making sure all tables, chairs, etc. are returned to their original setup before we used the facility. I understand and agree that while using any facility or equipment of Pray's Mill Baptist Church, I shall hold Pray's Mill Baptist Church harmless for any bodily injury and or property damage as a result of any and all activities while on their property—including but not limited to the buildings, recreation area, and parking lot.Consent* I agree to the terms and requirements listed on this formConfirm: (First and Last Name)*