Facility User Intake

Host Organization Information

Host organization is the entity accepting all financial responsibility for the event, and shall either provide the required insurance or ensure that it is provided by the Event Organizer.

Type of Organization



Event Organizer

Event Organizer is the person/entity given authorization by the applying organization to request use of the CBU facility.

Secondary Organizer

It is recommended that Event Organizer provide contact information for a Secondary Organizer.

Only the authorized Event Organizer and Secondary Organizer will be able to make changes to this application.

On-Site Contact

Facility Requested (check the box that applies/state the facility requested)






















Event Type













Please indicate wheather the Event includes:
Fundraising
Religious service


Additional Event Detail

Event Set-Up & Tear-Down (required for each day and time)

Staging Details

The following items will be used at the event (please mark all that apply):







Location/Venue Site Plan

All applicants are required to submit a detailed site plan. The required plan is to be submitted on 8 ½” x 11” or 8 ½” x 14” white paper and must include a directional indicator showing N, S, E, and W. The plan must also include a key to indicate people, vehicles, first aid station(s), vendor location(s), cooking station(s), food table(s), platform(s), barricades, etc. It need not be to scale but must accurately represent the desired layout using approximate measurements and/or on-site landmarks. If a computer program is used to generate the site plan/map, the font used must be no smaller that size 10.

Equipment/Services Requested from the University (provided at additional cost)













Insurance

The Host Organization and/or Event Organizer must provide a General Liability Insurance Certificate providing evidence of general liability insurance coverage in the minimum amount of $1,000,000 combined single limit, $2,000,000 aggregate AND $1,000,000 Auto Liability if the event includes any moving vehicles including golf carts AND an additional insured endorsement naming “California Baptist University, its trustee, officers, agents, servants, affiliates and employees as additional insured.” This document must be submitted no later than fifteen (15) days prior to the event start date. All vendors participating in the event must provide insurance as well as all contracted service for the event including but not limited to, security services, rentals, etc.

Indemnification Agreement

The Host Organization and/or Event Organizer must submit an indemnification agreement containing language as follows:

“(Insert name) agrees to indemnify, defend and hold CBU its trustee, officers, agents, servants, affiliates and employees completely harmless from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fee, directly resulting from the negligence, actions or omissions of (Insert name/event) and to reimburse CBU for such expense incurred.”

Medical Plan

All events are required to have a medical aid plan to provide service in case of injury or serious illness. At a minimum, this plan must provide for the Event Organizer, Secondary Organizer, and/or Contact to assess the circumstances, call 9-1-1, call CBU Safety Services, and remain with the injured/ill person until arrival of CBU Safety Services staff. Depending upon type of event and/or projected attendance, the Host Organizer may be required to have a First Aid Station on site and to show the location of that service on the Site Plan/Map.

If providing this service through an ambulance company, please provide the following information and attach copies of their Business Tax Certificate, Liability Insurance, and California State License.

If complying with this requirement through contract with a doctor, RN, and/or EMT Staff, please provide the following information and attach a copy of their identification credentials.
Evacuation Plan