Event Request Form

Name *

First Name

Last Name

Today's Date *

MM

DD

YYYY

Phone *

(###)

###

####

Event start date *

MM

DD

YYYY

Event end date *

MM

DD

YYYY

Event start time *

Hour

Minute

Second

AM PM

Event end time *

Please note: All events meeting on campus need to end by 8:30pm

Hour

Minute

Second

AM PM

Does this event repeat?

Yes

No

Please select if you are requesting this event to be listed on our website *

Yes (Please provide information in next text field)

No

Does your event require registration? *

Yes

No

Is there a cost associated with this event? *

Yes

No

Please select which rooms/areas you are requesting: *

Outdoor/Patio Space

Main Auditorium (200 Person Limit)

Student Center (100 Person Limit)

Life Kids Center (80 Person Limit)

New Life Café (70 Person Limit)

Room 102 (15 Person Limit)

Room 103 (15 Person Limit)

Connection Hub (15 Person Limit)

Creative Room (10 Person Limit)

Kitchen

Parking Lot

Other

Does your event require room set-up? *

Yes, the room will need to be set up for my event

No, the room can be left as-is for my event - I will not be moving any furniture

What equipment & tech personnel are you requesting? *

Please note: charges may apply. See "Summary of Charges" below.

Computer* (presentations and media)

Sound System*

TV/DVD

Video Projector

Other

None

Will there be food and/or beverages served at the event? *

Yes

No

Facility use guidelines *

In requesting the use of the facility, I take full responsibility to make sure that the room is cleaned up and all tables, chairs, equipment etc. are returned to their original placed after the event is over. If the kitchen is being used, I also take responsibility in making sure that all trash is taken out and that the dishes are cleaned and put away. I will ensure that the thermostat is set at 78 degrees when I leave. I also understand that any/all technology equipment will not be used unless prior approval has been given. I agree to pay any and all Facilities and Tech personnel the agreed upon amount prior to the start of your event.

I understand and will comply with the Facility Use Guidelines (if an additional facility agreement is required, you will be notified.)

Summary of charges *

If Set-Up Requested: A trained Facilities personnel must be present during allocated set-up and tear-down time. A minimum fee of $100/personnel for the first two hours, with an additional cost of $50/hour/personnel, not to exceed $300/day/personnel, will be assessed. If Tech Equipment Requested: If you need any equipment, a trained tech personnel must be present to set-up, operate, and tear-down any technology equipment during your event. A minimum fee of $100/personnel for the first two hours, with an additional cost of $50/hour/personnel, not to exceed $300/day/personnel, will be assessed. If No Tech and No Set-Up Requested: If your event falls outside of normal NLCC Office hours (M-Th, 8am-4pm), a trained facilities personnel must be present to unlock, disarm, lock, and re-arm the building after the event. Since this falls outside of normal office hours, a charge of $100 for the first 4 hours, plus $50/hour after 4 hours, will be assessed. If your event falls during normal office hours, no charge for this will be assessed. Final cost could be adjusted at the discretion of New Life Community Church.

I agree to pay any agreed upon charges to the appropriate personnel, before the event begins.