Mount Vernon Nazarene University - Events Services, Facility Rental, Conferences, Room Reservations

Organization Details

Name of Organization:

First Name of Responsible Person:

Last Name of Responsible Person:

Phone Number:

Email:

Address:

City

State:

Zip:

Reservation Details

Event Starts:

Event Ends:

Set-up Starts:

Tear-down Ends:

Area(s) Requested

Proposed Activity (detailed description for each room please)

Special Set-Up Needs (tables, chairs, etc)

Special Sound/Lighting Needs (mics, projector, etc)

Number of Guests

Do you require Pioneer College Caterers?

Yes No

If yes, contact Robert.Stiltner@mvnu.edu 740-397-9000 ext. 4471.

Insurance Details

Does your group have insurance for this activity?

Yes No

If 'Yes', please submit a Certificate of Insurance list MVNU as an "Additional Insured" for this activity

If 'No', either MVNU will add an additional charge for supplemental insurance coverage, or re-evaluate your application before granting permission to use its facilities for this event

By signing this application, your group acknowledges and agrees that it assumes all risk and liability for harm to its members or their guests which may arise from the use of MVNU's buildings and grounds, and releases MVNU from any such liability, for which your group shall hold MVNU harmless, and further that your group will comply with MVNU's conditions and regulations outlined in the Facility Use Agreement (back page).

Who is submitting this form?

First Name

Last Name

Position

Phone

Questions?

Contact:

Event Services
(740) 397-9000, ext. 4603
eventservices@mvnu.edu