Facility Use REQUEST
Facility Use Process
HBC Request Process
Risk Management Approval
Approved
Denied
Operation Approval
Approved
Denied
CP/Host Approval
Approved
Denied
Host Name
Host Name
First
First
Last
Last
Host Email
Host Phone
HBC Agreement Details
Event Description
Exempt Purpose
Agreement Date
Term # of Days
Term # of Hours
Use Expense Fee
$
HBC Provided Ancillary Services
Audio/Video Media
Equipment
Security
Technical Support
Building Services/Set Ups
Athletics/Sports Addendum
Yes
No
Other
Contact Information
Name
*
Name
First
First
Last
Last
Phone
*
Email
*
Best way / time to contact you
*
Describes your facility use request
Select the reason that best describes your facility use request
*
Athletic/Sporting Event
Special Event
Ministry Event
Describe your event
*
List your expected attendance
*
minimum
List your expected attendance
*
maximum
Applicant Information
Who are you requesting for
*
Yourself as an individual
As a representative of an organization?
Registered Business/Organization Name
*
Registered Business/Organization Website
*
Onsite Contact - Name
*
Onsite Contact - Name
First
First
Last
Last
Onsite Contact - Email
*
Onsite Contact - Phone
*
Registered Business Mailing Address
*
Registered Business Mailing Address
Registered Business Mailing Address
Registered Business Mailing Address
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State/Province
Zip/Postal
Zip/Postal
Non-Profit
*
Yes
No
Type of business
*
Are you a Member or Regular Attender of a HBC Campus or HCA?
*
Yes
No
Are you age 18 or older?
*
Yes
No
Are you the person that will be onsite for the duration of the rental?
*
Yes
No
If not, identify the full name (first/last), age and role/title of the individual that will be
*
Event Details
Start Date
*
Start Time
*
12
1
2
3
4
5
6
7
8
9
10
11
:
00
30
AM
PM
End Date
End Time
*
12
1
2
3
4
5
6
7
8
9
10
11
:
00
30
AM
PM
Are any of these dates/times flexible?
Requested Campus Location
*
Rolling Meadows
Elgin
Crystal Lake
Aurora
Chicago Cathedral
North Shore
Detail your Facility Use Requirements
Will Trucks/Vehicles of any kind be used onsite during the event?
*
Yes
No
If yes, please detail
*
Are employees working onsite at any time during the event?
*
Yes
No
If yes, please detail
*
Will there be any activities onsite that require/utilize a participant waiver during the event?
*
Yes
No
If yes, please detail
*
Will there be direct care of minors and/or vulnerable populations while onsite?
*
Yes
No
If yes, please detail
*
Are there any special situations with special exposures while onsite?
*
Yes
No
If yes, please detail
*
Identify all locations / rooms and notate headcount estimates as applicable to your request for us to assess space availability
Room/Request Type
*
Classroom
Auditorium
Parking Requirements
Power Requirements
Signage Request
Tables & Chairs
Tents
Audio/visual or sound/projection media requests
Other exposures or special request Add-Ons
Athletic/SPorting Add-Ons: field prep, scoreboard, mats, locker rooms, etc.
Headcount
*
Notes
*
plus1
Add Request
minus1
Remove Request
If you are human, leave this field blank.
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