Facility Request Form 1.9999 Step 1 of 6 16% Please choose YOUR membership type, or your groups membership type, in relation to Gashland EPC* Member Non-Member Non-Profit Organization Contact InformationGroup/Organization NameYour First & Last Name* First Last Email* Contact Phone 1*Best phone number to reach you on the day of your event.Contact Phone 2Mailing Address* Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Please provide the name and contact information for the person responsible during the actual event.Name (If Different From Above) First Last Best Day of Contact Phone Number (If Different From Above) Renters Drivers LicenseA driver's license is required to complete your reservation.Are you able to upload a picture/scan of your driver's license now?Please select oneYesNoUpload Scan of Drivers License CopyIf you are unable to upload a copy, we need to make a copy at the time you come in to complete your reservation. Event Times & DatesDesired Date of Event or Meeting* MM DD YYYY Desired Time to Enter Building for Set Up* : HH MM AM PM Time Event Begins* : HH MM AM PM Time Event Ends* : HH MM AM PM Time You Will Be Exiting Building (Allow for Yourself Plenty of Clean Up Time from the Time Your Event Ends.)* : HH MM AM PM Total the hours you will be in the building from Set Up to Clean Up*This is the number of hours you will be charged for when booking a room. Please enter this number into the Number of Hours Requested box under each room you request use of. Event DetailsEstimated Number of Individuals Attending Event/Group Meeting*Please enter a number from 1 to 350.Fire Dept. Occupancy Load Disclaimer While the fire department requires us to display the following occupancy loads: Sanctuary-275; Chapel-8; Holy Grounds Cafe-80; Fellowship Hall-288; Ministry Center- 932; please know that we are only able to accommodate the seating capabilities listed earlier in the form. Please check any of the following available items you may need for your event: (An Additional Fee May Apply)* TV/DVD Basketball Goal(s) Sound System Screens/Video System None Event Details*Please provide us with some event details. How many tables/chairs you will need, if you are seating banquet style or theatre, If you will be serving food, doing arts & crafts, setting up props, types of activities you will be doing, etc. Room RequestsPlease select your desired room(s) for us to review. Please note all pricing is charged per hour and a total will be calculated at the bottom of this page. Additional charges may be added at the time of payment for use of our: TV/DVD players, Basketball Goals, Sound System, or Screens/Video System. Sanctuary - Member Price Per HourSeating Capabilities: 275 Seated Sanctuary $25.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitMember | SanctuarySanctuary | Non-Member Price Per HourSeating Capabilities: 275 Seated Sanctuary $75.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitNon-Member | SanctuarySanctuary | Non-Profit Price Per HourSeating Capabilities: 275 Seated Sanctuary $0.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitNon-Profit | SanctuaryFellowship Hall | Member Price Per HourSeating Capabilities: 100 Seated Fellowship Hall $0.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitMember | FellowshipFellowship Hall | Non-Member Price Per HourSeating Capabilities: 100 Seated Fellowship Hall $60.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitNon-Member | FellowshipFellowship Hall | Non-Profit Price Per HourSeating Capabilities: 100 Seated Fellowship Hall $0.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitNon-Profit | FellowshipChapel | Member Price Per HourSeating Capabilities: 80 Seated Chapel $0.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitMember | ChapelChapel | Non-Member Price Per HourSeating Capabilities: 80 Seated Chapel $30.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitNon-Member | ChapelChapel | Non-Profit Price Per HourSeating Capabilities: 80 Seated Chapel $0.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitNon-Profit | ChapelMinistry Center | Member Price Per HourSeating Capabilities: 350 Seated Ministry Center $25.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitMember | Ministry CenterMinistry Center | Non-Member Price Per HourSeating Capabilities: 350 Seated Ministry Center $100.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitNon-Member | Ministry CenterMinistry Center | Non-Profit Price Per HourSeating Capabilities: 350 Seated Ministry Center $0.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitNon-Profit | Ministry CenterSound or Video Tech | Price Per Hour*A sound or video tech is required to be hired for your event if you have asked to use our sound systems, screens/video systems for Member, Non-Member, and Non-Profit events.Sound or Video Tech $35.00/hrNumber of Hours Requested from Time Enter Building to Time Exit*Holy Grounds Cafe | Member Price Per HourSeating Capabilities: 80 Seated Holy Grounds Cafe $0.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitMember | Holy GroundsHoly Grounds Cafe | Non-Member Price Per HourSeating Capabilities: 80 Seated Holy Grounds Cafe $30.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitNon-Member | Holy GroundsHoly Grounds Cafe | Non-Profit Price Per HourSeating Capabilities: 80 Seated Holy Grounds Cafe $0.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitNon-Profit | Holy GroundsSingle Classroom | Member Price Per HourSeating capabilities and capacities vary per classroom. Single Classroom $0.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitMember | Single ClassroomSingle Classroom | Non-Member Price Per HourSeating capabilities and capacities vary per classroom. Single Classroom $20.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitNon-Member | Single ClassroomSingle Classroom | Non-Profit Price Per HourSeating capabilities and capacities vary per classroom. Single Classroom $0.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitNon-Profit | Single ClassroomDouble Classroom or Reception Room | Member Price Per HourSeating capabilities and capacities vary per classroom. Double Classroom $0.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitMember | Double ClassroomDouble Classroom or Reception Room | Non-Member Price Per HourSeating capabilities and capacities vary per classroom. Double Classroom $30.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitNon-Member | Double ClassroomDouble Classroom or Reception Room | Non-Profit Price Per HourSeating capabilities and capacities vary per classroom. Double Classroom $0.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitNon-Profit | Double ClassroomSpecial Event NeedsBelow are special requests that incur an extra charge because church approved individuals must be present while resources are in use. Kitchen & Kitchen Supervisor | Fellowship Hall or Ministry Center Kitchen | Member Price Per HourThe reservation of a Kitchen Supervisor is required when you use either kitchen. The Kitchen Supervisor is needed for Member, Non-Member & Non-Profit events. Ministry Center or Fellowship Hall Kitchen $10.00/hr | Kitchen Supervisor $35.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitMemberKitchen & Kitchen Supervisor | Fellowship Hall or Ministry Center Kitchen | Non-Member Price Per HourThe reservation of a Kitchen Supervisor is required when you use either kitchen. The Kitchen Supervisor is needed for Member, Non-Member & Non-Profit events. Ministry Center or Fellowship Hall Kitchen $25.00/hr | Kitchen Supervisor $35.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitNon-MemberKitchen & Kitchen Supervisor | Fellowship Hall or Ministry Center Kitchen | Non-Profit Price Per HourThe reservation of a Kitchen Supervisor is required when you use either kitchen. The Kitchen Supervisor is needed for Member, Non-Member & Non-Profit events. Ministry Center or Fellowship Hall Kitchen $0.00/hr | Kitchen Supervisor $35.00/hrNot NeededNumber of Hours Requested from Time Enter Building to Time ExitNon-ProfitTotal $0.00 Please note, additional fees will be applied at the time of your final payment for use of our TV/DVD players, basketball goals, Sound System, or Screens/Video System. Security DepositMembers, Non-Members, and Non-Profits are required to provide a security deposit. Have you asked to use the Ministry Center, Fellowship Hall, or Sanctuary for your event? Yes No Security Deposit* $50.00 Security Deposit* $250.00 Security Deposit* $250.00 Facility Use PoliciesPlease read and review our facility use policies below and sign in agreement before going to the next page. I have read the above policies & agree* Yes Signature*I, the responsible party, have read all of the Facility Use Policies listed herein and have reviewed the pricing for Facility Use. I agree to comply with the policies and pricing set forth by Gashland Evangelical Presbyterian Church regarding the use of the church facilities for our event or group. I, the undersigned, take full responsibility for any damage and/or breakage of church property and equipment during my use of the facilities and understand my deposit may be forfeit, or my event may be cancelled if damage, breakage, or any violation of GEPC's Facility Use Policy takes place.
