Facilities Request - Community Event

Please fill out the form below (this form is for Community Events - for Hibernia Events, click here):

Event Name *
Which Building(s)	WCI (minimum 300 people)   WCII (minimum 75 people)   Ed Bldg I   Ed Bldg II   Ed Bldg III   Ed Bldg IV   Ed Bldg V
For Date and Time *	01 02 03 04 05 06 07 08 09 10 11 12 MM / 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 DD / 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 YYYY 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 HH : 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 MM AM PM AM/PM
End Time	00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 HH : 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 MM AM PM AM/PM Please make sure your event is over by 8:30 p.m., and everyone needs to be out of the building. On Saturday, your event will need to be over by 5:00 p.m. The building must be reset, cleaned and ready for Sunday use by 5:00 a.m. Please make sure you get ALL of your material off the premises by that time.
If you need additional days, please list the dates MM/DD/YYYY and the start and stop times (indicate am or pm)
Contact Person *
Prefix
First *
Last *
Suffix
Phone Number *	### - ### - ####
Email *
Video
Will your event require video?	Yes   No  If yes, the video must be delivered to the church office 3 days prior to the event. On the line below, please indicate the type of video you will be using (MP4, AVI, DVD, etc.)
Video type:
Does your video have sound?	Yes   No
Computer
Will your event require the need for a computer to display:	Power Points   Song Lyrics   Other (please indicate below)
Other computer need:	Please note: All songs, lyrics, power points displays will all request approval from our media ministry. Therefore they must be delivered to the church office 3 days prior.
Sound
Will your event require a sound system?	No   Yes, for sound   Yes, for singing   Yes, for audio presentation  If you checked any of the yes boxes above, please fill out the explanation box below indicating exactly what you are needing.
Explanation of Sound Needs:
Lighting
Will your event require any special lighting needs?	Yes   No  If yes, please explain in the box below.
Explanation of Lighting Needs:
Set-Up
How many people are you expecting?
Do you need chairs?	Yes   No
Do you need tables?	Please indicate round or long.
Miscellaneous Information
Please add any additional comments here.
Building Reset and Clean-Up The person who is submitting the form is responsible for resetting the building according to a layout that will be given to them. The group is also responsible for all cleanup (including vacuuming, taking out the trash, bathrooms, etc). If your group wishes to have the church be responsible for the reset and clean-up, a fee will be determined at the time your request is accepted.
Building reset and clean-up	I will be responsible for reset and cleanup   I decline and will pay for the reset and cleanup
Thank you for your request. Please note, this is just a request. We will have to see if a staff member is available to be here and take care of unlocking, locking and alarming the building. After you hit submit, you will receive an email letting you know we have received your request. Another email will be sent when your event has been approved. If you use sound/media the following cost will apply:   (Minimum 2 Hours)   Up to 2 hours $50   2 to 4 hours $75   4 hours to 6 hours $100   6 to 8 hours $150   8 to 10 hours $175 You will also be notified in your 2nd email of any additional cost associated with the approval of your event. Hibernia Baptist Church is a smoke-free and alcohol-free campus. By submitting this form you are agreeing to this clause and will ensure that your event is smoke and alcohol free.
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