Third Party Special Events Waiver Request

Location Information

Location Number (4 Digits):*

Location Name:*

Location Address:*

Location City:*

State:

Zip:

Location Contact:*

Email Address:*

Your Phone Number:*

Fax Number:

Lessee Information

Lessee Contact:*

Address:*

City:*

State:

Zip:

Lessee Phone Number:*

Lessee E-mail:

Please specify the type of special event
(E.g. Wedding Reception, Anniversary party, etc.):*

Date of Event:*

Time of Event:*

Approximate Number of Participants:*

Is Liquor Being Served:*

Is Food Being Serverd:*

Is There Security:*

Special Instructions / Comments:

Any additional notes you would like to add.

THE COST FOR THIS WAIVER IS $100.00 FOR EVENTS TO BE HELD BETWEEN JULY 1, 2019 AND DECEMBER 31, 2019.
EVENTS TO BE HELD BETWEEN JANUARY 1, 2020 AND JUNE 30, 2020, COST FOR THE WAIVER IS $110.00

Checks are to be made payable to ARCHDIOCESE OF BALTIMORE.

By submitting this request, the lessee has requested that the insurance requirement within the thrid party facility use agreement be waived. Neither the Archdiocese nor the respective location is in the business of selling insurance. This transaction represents a waiver of a contract condition and fulfills the lesse's obligation to providing proof of insurance.

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Third Party Special Events Waiver Application Request Form