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Complete this form. Email office@clairmontpres.org with additional questions.

Facility Use Request

Requestor's Name (first, last)*

Group or Organization*

Address*

Email*

Phone

Is group or organization incorporated?

Yes

No

Is group or organization for-profit or non-profit?

For-Profit

Non-Profit

Other

Reason for request (how do you intend to use the facility)?*

Rooms requested:

Sanctuary: Capacity 469 people

Fellowship Hall: 1,767 sq. ft

Atrium/Kitchen/Serving Window: 1,265 sq. ft

Classroom 102: 780 sq. ft.

Youth Classroom: 735 sq. ft

Youth Lounge: 519 sq. ft

Classroom 106: furnished with adult sized furniture + 85 inch screen + private bathroom

Classroom 108: furnished with elementary school sized children's furniture (no screen) + private bathroom

Conference Room: 269 sq. ft. w/ 10 chairs

Large Open Office area: 896 sq. ft. w/ large conference table

Band Room: 587 sq. ft.

Choir Room: 697 sq. ft.

Kichen/Food Serving Area: 498 sq. ft.

Other

Date and Time of Use

Month

Day

Year

Time

:HoursMinutes

Number Participating:

When would you like to arrive?

Time

:HoursMinutes

When do you plan to depart?

Time

:HoursMinutes

Name and contact information of person responsible during use:

Is this person 21 years or older?

Yes

No

Estimated set up time:

Estimated break down time:

List any specific needs or equipment requests:

Does your group or organization have General Liability Insurance that would apply during use of facility?

Yes

No - if no, you will be required to sign an indemnification and hold harmless agreement.

If you have General Liability Insurance, will you provide a certificate naming Clairmont Presbyterian Church as an additional insured?

Upload General Liability Insurance document:

What is the amount of insurance limit?

Signature*

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ABOUT CLAIRMONT >

The purpose of the members of Clairmont Presbyterian Church is to know Jesus Christ as Lord and Savior and make Him known to others through faithful worship, study, fellowship, stewardship, and service.

CONTACT INFORMATION

T: 404-634-3355

E: office@clairmontpres.org

1994 Clairmont Road, Decatur, GA 30033

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