360-318-9525 (office) 360-318-1094 (fax)
$25 non-refundable fee to reserve your
date
(use fee will be determined by the latest facility rental schedule)
NAME OF APPLICANT OR ORGANIZATION: ________________________________
ADDRESS: _______________________________________________________________
PHONE NUMBER: _________________________ E-MAIL: ______________________
DATE: ______________ PERSON IN CHARGE OF EVENT: ______________________
FACILITIY REQUESTED: __________________________________________________
TYPE OF ACTIVITY: ______________________________________________________
TIME OF USAGE: _________________________________________________________
WHAT TYPE OF SUPERVISION WILL BE PROVIDED: _________________________
WILL THERE BE AN ADMISSION CHARGE:(CIRCLE ONE) YES NO
WILL THERE BE ANY FOOD SERVED: (CIRCLE ONE) YES NO
IF YES, WHO WILL BE PROVIDING THE FOOD: ______________________________
Number of persons expected to attend this event: ______________
Will the Friends of Lynden Christian School be involved in any capacity? YES NO
If yes, in what capacity? Catering Serving/Cleanup Kitchen coordinator
Contact Arlene Scholten, 354-8123 for the Friends of LC catering
Is it likely that your group will assist the janitor with setup and/or cleanup? YES NO
WILL YOU NEED:
Chairs Tables Microphone Stage Lighting
Podium Piano Keyboard Sound System
Stage Risers Other
Special Set up Instructions: ___________________________________________________ _________________________________________________________________________
_________________________________________________________________________
Please read the following statement and sign below:
The undersigned agree to
assume full responsibility for the care of the facility used. It is understood that the organization or
individual user will be responsible for the behavior of the group and to
indemnify and hold harmless Lynden Christian School Board and Society against
any claim for damages, compensation or otherwise on the part of any member of
the group or person using the facility.
Should any damages result to the facilities as a result of our usage, we
will be responsible to insure full restitution.
Signed:
__________________________________________
Date: ____________________________
For office use only
Approved _____ Copies to: Building Janitor Friends of LC _______________
Date _________ ______________________ Kitchen Coordinator
_________