Bethany UMC Facility Use Request Form for Scouts

This request form is specifically for use by representatives of area Scouting organizations (Boy Scouts, Girl Scouts, Cub Scouts, Brownies, etc.). If you are requesting use of the Bethany UMC facilities for any purpose other than a Scouting event, you must use the Bethany Facility Use Request Form, which is available on the church website (www.bethany-umc.com) or by writing to hmerrithew@bethany-umc.com.

User Information

* Name of Organization (i.e., "Girl Scouts of the Lowcountry" or "Boy Scouts of America Troop 787")

* Den or Troop Name/Number

* Age(s) of participating scouts

* Today's Date

Meeting Details

* Date(s) Facility Needed
(If recurring meetings, please
list start and stop dates.)

* Day of the Week

* Purpose of Meeting

* Set Up Start Time

* Event Start Time

* Event Finish Time

* Clean Up Finish Time

* Number of Meetings

* Frequency of Meetings

* Number of Attendees

Facilities Requested

* Check the Room(s) Requested

Responsible Party or Parties

All events must have a Bethany UMC member or Scouting representive agree to be responsible for supervision of children and adherence to Bethany UMC facility use guidelines. Please list the name of the Bethany member or Scouting representative.

* Name of Representative

* Title/Position

* Representative Street Address

* City

* State

* Zip Code

Work Phone

Other Phone

* Respresentative Email Address

You Must Read and Agree to the Bethany UMC Property Regulations

* I have read the Bethany UMC's regulations for use of church facilities and agree to abide by the stated policies as defined by the Bethany UMC Board of Trustees.

Yes

No

To Be Completed by Bethany UMC

Calendar Confirmation

Approved:_____ Disapproved: _____ Date:___/___/___ Calendar Staff Signature: ________________________________

Trustees Approval/Disapproval

Approved:_____ Disapproved: _____ Date:__/__/__ Reason for Disapproval: ________________________________

Signature of Trustees Chairperson:___________________________________________________________________________

* Indicates Response Required

Fellowship Hall (entire hall)	Front Half of Fellowship Hall
Back Half of Fellowship Hall	Friendship Circle Classroom
Sanctuary	Kitchen
Classroom (small)	Classroom (large)
Playground	House (303 Central Ave.)
Gym (contact Bethany's gym)	Parking Lot
Spell Chapel	Art Room
Other