APPLICATION FOR USE OF CHURCH FACILITIES
Please fill out form and mail or fax to:
Church of the Pacific
4520 Kapaka Road, PO Box 223154, Princeville, HI 96722
Email: info@church-of-the-pacific.org
808/826-6481 (Church) - 808/ 826-6228 (Fax)


Today’s Date:________Name of Organization:____________________________________

Name of person responsible:___________________________________________________

Street Address:______________________________________________________________

City & Zip Code_____________________________________________________________

Phone:_________________________ Cell Phone:__________________________________

Date(s) Requested__________________Time From:____________ Time To:___________

Briefly describe proposed event:________________________________________________
___________________________________________________________________________

Facility Needed:
Sanctuary_______ Community Hall (Hale Aha)_______ Kitchen________ Gazebo_______
Equipment Needed (how many of each):
Tables______________ Chairs__________________ Sound System___________________
Number expected to attend:_____________ Will beer or wine be served?______________
CHARGES FOR THE EVENT WILL BE PAID PRIOR TO THE EVENT.
DEPOSITS
Damage Deposit (to be refunded after inspection) $ 200.00
Key Deposit (refundable after return of key) $ 25.00
Special Key Pick up (not in business hours) $ 25.00
RENTAL FEES
Room: C-Hall, Sanctuary, Gazebo, Kitchen $____________
Amount Quoted for use of Facility $____________
Amount Paid at time Facility is Reserved
Date Paid__________________ Invoice#___________________ $____________
Balance Due (to be paid day before event) $____________
Total of Refund to be paid $____________
Date Paid__________________ Check#____________________ $____________
Church of the Pacific
4520 Kapaka Road, PO Box 223154, Princeville, HI 96722
Email: info@church-of-the-pacific.org
808/826-6481 (Church) - 808/ 826-6228 (Fax)

CONTRACT CONDITIONS FOR USE OF FACILITIES.

One primary mission of the Church of the Pacific is to provide support and facilities for community services, meetings, education, youth, and cultural events. The church incurs administrative, utility, maintenance, and other expenses in carrying out this mission. Recovery of those costs are by donations and Facility Usage Fee Schedule that is attached

Reservation shall be considered to be approved only when the Church of the Pacific Usage Committee or its delegate accepts the application the applicant agrees to pay at that time the cleaning/damage deposit for the size of the group and facility to be used, as specified in the attached Facility Usage Fee Schedule.

In the case where reservations are made in advance of the function, the applicant agrees to pay the full usage fee 60 days before the event. In the case of other applications, the applicant and agrees to pay the full usage fee according to the timetable set forth in the Facility Usage Fee Schedule.

The applicant agrees that a cancellation will entail forfeitures of the usage fee deposit according to the conditions described in the section on conditions of use.

Sponsors of long-term events, lasting a week or more or that occur regularly, agree to provide prior to use of the facility proof of a current comprehensive and general liability insurance. The coverage shall include: 1, coverage of the premises and operation, products and their operation, alcohol liability, blanket contractual liability, personal injury and adversary injury, and broad form property damage. 2. Limits of liability shall be $1 million for combined single limit and bodily injury and property damage. 3, Occurrence forms. 4, The Church of the Pacific shall be named as an additional insured. 5, A 30-day notice of cancellation is to be provided. 6, A statement that the user’s policy contains a clause stating that the user’s policy is primary to any policy Church of the Pacific may have in force, which applies to a loss, covered hereunder.

RELEASE AND HOLD HARMLESS AGREEMENT:
The undersigned expressly releases the Church of the Pacific and, its members, employees and agents (hereafter Church) from any and all liability for any damage, injury or loss including personal injury and property damage, which may result from the use of the Church premises. The Undersigned further agrees to indemnify and hold harmless Church against all claims demands and losses including property damage and personal injury arising out of or in connection by the undersigned with the use of the Church premises and to reimburse Church for its cost any expenses including attorney fees.

Print Name: ________________________________.

Signature: ________________________________________.Date: ______________________.