Congregational Church of South Hero
United Church Of Christ
P.O.Box 99, South Hero, Vermont 05486
(802) 372-4962
e-mail soheroucc2@earthlink.net

Table or Chair Use Request Form

Today's date: _____________________________

Name of organization: ___________________________________________________

Requested date(s) of use: _____________________________________________

Time requested: From _______________ To _________________

# of tables needed: _______ # of chairs needed: _________

** Our church is a busy place. Please do not remove tables and/or chairs before the day & time requested and approved. Please return the borrowed items within the agreed upon time frame. **

Contact person of organization:_________________________________

Mailing address: ______________________________________

Phone: _____________________ E-mail address: ____________________

Do you need a key for access to the building? _______

Additional notes or explanations, (if any): ______________________________________

_____________________________________________________________________

Tables and chairs are loaned out as available with prior permission from the Board of Trustees. Any event within the building has priority. ONLY tables marked with orange on the ends may leave the building. It is expected that you will return them promptly in clean and undamaged condition.

Please mail or e-mail this form to the Board of Trustees at the above address for their consideration. The Board of Trustees meet on the Third Tuesday of the month. Applications should be received prior to these regularly scheduled meetings.

We believe it to be a mission of this church to serve the needs of this community. Understand that tables and chairs have a finite lifespan, and replacement is costly. Contributions towards ongoing replacement are gratefully accepted.

Suggested minimum contributions:

$1 per chair
$5 per table

I have read the provisions contained in this agreement, and accept them as stated. I further understand that church functions and activities take precedence over other community uses, and that at times such church functions may preempt previously approved community uses.

Date: _______________ Representative's signature: __________________________________

Trustees: Approved:____________ Date: _____________________________

Tables and chairs taken: _____________________

Returned: ______________________

Any additional notes: _______________________________________________________