APPLICANT Name: Group Name: Address: City,State,Zip: Phone: DATE(s) OF USE: DESCRIPTION OF USE: WEDDING (if applicable): Groom: Bride:

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Nestled in the quiet suburbs of Hanover County, Virginia lays one of the greatest historical churches of our time. Pastoral environs frame this one of a kind, open-air church site where Patrick Henry attended as a young boy. A wedding in this natural setting perfectly complements the rich history that defines the place. Situated on over 110 acres of protected view shed, the Polegreen church site is an elegant, yet understated, place to host your wedding. The open fields provide for an additional space for a tented reception. The Visitor s Center offers amenities such as restroom facilities and a bridal changing room. Marriage celebrant may be available upon request. Polegreen invites you to make your own history here. The Foundation hopes you will be captivated by the preservation and serenity of one of America's most important historic sites. For more information on hosting your special day at Polegreen, please visit www.historicpolegreen.org and click on Host Your Special Event at Polegreen. Beth Young Historic Polegreen Church Foundation P.O. Box 2111 Mechanicsville, VA 23116 (804) 730-3837 Email: admin@historicpolegreen.org Website: www.historicpolegreen.org Weddings * Rehearsal Dinners * Executive Meetings * Group Tours :

Historic Polegreen Church Foundation Use of Polegreen site is permissible with the completion of this application and written approval of the Foundation. Any changes in the planned use from that stated in the application will require confirmation of the change and its approval. APPLICANT Name: Group Name: Address: City,State,Zip: Phone: Email: DATE(s) OF USE: DESCRIPTION OF USE: WEDDING (if applicable): Groom: Bride: Rehearsal Time: Setup Time: Event Start/End Time: Is your group a non profit, civic, or educational entity? Yes: No: How did you hear about Historic Polegreen Church Foundations? Fee Structure: Facility Use (full): $1000 - Includes use of structure, parking, conference room, restroom facility and event signs. Conference Room Rental (includes restroom) or limited rental (by special permission only): $100 Guided Tour: $5/pp for 1-10 persons; $75 flat fee for 11 and above Cleaning and Damage Deposit: $400 for full rental; $50 for conference room rental *********************************************************************************** All weddings are allotted a one hour rehearsal the day before the ceremony. You must note your request above. Each event is allowed to setup no more than four (4) hours prior to your start time. All times requested must be approved by the Foundation staff. The church silhouette can accommodate approximately 125 chairs. The Foundation does not provide chairs. DUE WITH YOUR APPLICATION: A 50% deposit of the facility fee must be submitted with this application within seven (7) calendar days of this reservation in order to hold the event date. The deposit is non-refundable. Balance is due thirty (30) days prior to event. If event is booked less than 30 days prior to the event, the entire amount is due at the time of application. If event is cancelled after full payment has been made, you forfeit the $500 deposit. There are no refunds due to inclement weather. The cleaning and damage deposit is separate from the facility fee. It is also due with your reservation deposit and must be made via check as we hold the check. You will be refunded the damage deposit provided all terms of the agreement are met as outlined below. See full terms below. INITIAL: Make checks payable to: Historic Polegreen Church Foundation or use your Visa/MasterCard/Amex/Discover at www.historicpolegreen.org/give Cleaning/damage deposits only must be made via check; no credit cards accepted. Submit completed application to: Historic Polegreen Church Foundation, Attention: Facility Use, P.O. Box 2111, Mechanicsville, Virginia 23116.

The undersigned agrees that the applicant and/or responsible person are familiar with, and will assure compliance with, the terms and conditions stated below of the Historic Polegreen Church Foundation. Applicant signature: Date Terms and Conditions Rules and Conditions for use of Historic Polegreen Church Foundation Site The following rules and conditions of the Historic Polegreen Church Foundation site shall apply to all use of the Polegreen Site. 1. All use shall conform to the planned use described in the Application" and approved by the Foundation. 2. The Polegreen Church is a historical structure. No use shall damage the structure or in any way diminish its historical integrity. 3. The applicant shall be solely responsible for the security of the site, restroom facilities, and grounds during period of use and shall leave the building secured at all times when no one is present and responsible for security. 4. The Foundation shall have no responsibility for any personal property of the applicant on the premises. 5. No nails, tape, tacks, staples, screws, or fasteners shall be used on the interior or exterior walls, doors or floors of the site, structure or restrooms. The applicant shall leave the site, restrooms, and grounds as found. No beverages are allowed on the conference room table or buffet without proper protection from damage. In addition, no ladders of any kind may be used to lean into the structure for decoration purposes. An A-frame ladder may be used instead. 6. The applicant should inspect the site, restrooms, and grounds in advance of the proposed use with a member of the Foundation Staff to determine most effective use possible. Appointments can be arranged. 7. Public drunkenness, illegal drug use, and tobacco use will not be tolerated. The host will be responsible for removing any person violating this policy. 8. Noise - The facility may be utilized for events between the hours of 9:00a.m. and 9:00p.m. Due to the neighborhood surroundings of the facility, noise from music or otherwise must be kept at a moderate level at all times out of respect for our neighbors. 9. Departure of the bride and groom may be celebrated; however, no rice, confetti, or birdseed may be used. Live flower petals and bubbles are acceptable. 10. Use of Vendors The applicant is solely responsible for the hiring of all vendors to accommodate their event. The Foundation uses preferred vendors (see below) for all of its events. Applicant is welcome to contact preferred vendor for their use. Applicant is responsible for obtaining and displaying all valid permits, including ABC licenses, in accordance with the law and to the satisfaction of the Foundation. Applicant is required to provide the Foundation with the contact information for all vendors contracted for their event. This information shall be supplied no later than 30 days in advance of event. 11. The applicant shall be responsible for removing all decorations and other materials from the property promptly after the completion of the use. The applicant shall also promptly notify Foundation staff if any damage to the property (building and contents, yard, and parking area), is done. All décor and trash must be removed from the Foundation premises by open of business the next morning (9am). Should the site not be cleaned within the allotted timeframe, the Foundation may remove such at the expense of the Applicant. 12. The applicant shall not have keys to the site or restrooms reproduced, and shall return all keys following the use of the property. The building is protected by an alarm system that will be explained when first visiting the site. 13. Cleaning and Damage Policy - The applicant will be notified within 30 days of the event if damages are found due to inspection of the site by the Foundation and/or non-compliance with any terms and conditions listed in this packet of information. All damages will be submitted to applicant in writing and payable to the Foundation. 14. Severability Invalidity or unenforceability of one or more provisions of the Terms and Conditions shall not affect any other provision of this Terms and Conditions.

15. The Foundation makes no representations or warranties concerning the condition of the structure or the grounds and shall not be liable for any injuries, deaths or damages arising out of or in connection with proposed use of the site. The applicant agrees to indemnify and to hold the Foundation, staff, officers, directors, and trustees harmless from any liability arising out of or in connection with the proposed use of the site, restrooms, and grounds. 16. The Foundation reserves the right, in its discretion, to amend or modify these rules and conditions and to impose on any applicant for use of the facility additional rules and conditions specific to the planned use. ************************************************************************************* Guided Tours Policy Guided tours of the grounds must be scheduled in advance by calling the Foundation offices or by email. Self-guided tours are free of charge. All group functions that may impede the general public from full use of the facility must be scheduled under our Facility Use policy. The Foundation grounds are staffed on various days of the week by appointment only. Preferred Vendors: GARNISH (Catering) BLACK CREEK FLOWERS AND SWEETS (Flowers) Louis Campbell Erica Hutchison 804-262-5787 office 804-781-1773 Email: LOUIS@GARNISHRVA.COM Email: mail@blackcreek-flowers.com Website: www.garnishrva.com Website: www.blackcreek-flowers.com THE PROP SHOP (Rentals) Tom Coover Phone: (804) 228-1100 Fax: (804) 228-1656 Email: tom@propshoppartyrentals.com COMMONWEALTH EVENT COMPANY (Rentals) CAROLINE MARTIN (photography) Phyllis Andrews Phone: 804-928-3688 Phone: 804-264-6621 weddings@carolinemartinphoto.com Email: info@commonwealthevent.com Website: www.carolinemartinweddings.com *If Applicant wishes to use another vendor, Applicant must get prior approval by the Foundation. Selected Vendor: Company Name: Service Provided: Contact Person: Phone Number: Selected Vendor: Company Name: Service Provided: Contact Person: Phone Number:

Facility Use Cleaning & Open/Close Checklist A scheduled walkthrough must be made the week prior to your event. In addition, the failure to complete and leave this checklist as noted will result in the forfeiture of your security deposit. Entry to building: 1. Unlock the barn doors and conference room with supplied keys and DISARM building with code given by punching in code + OFF. The supply closet will be found unlocked. All decorations and trash used must be removed from the site by the following morning. Event and parking signage must be picked up and placed in the closet in the conference room. Place all furniture as you found it in the conference room; the console table and the Bluford portrait may not be moved. Turn off all lights when you are ready to alarm building. All cleaning materials and trash bags can be found in the closet in conference room. Staff will review location with you on your walkthrough. No Polegreen items such as coffee, water, napkins, etc may be used. You may use paper towels. Bathrooms and conference room must be left in broom swept condition; a broom, vacuum cleaner and swiffer dry mop are available for your use and must be placed back in the closet when finished. The conference table and console must be wiped down with supplied furniture polish wipes only upon completion of your event. No other cleaner is acceptable. The leather mats may be removed or used at your leisure. They may be wiped down with a Clorox wipe. The countertops must be wiped down with a Clorox wipe. Carpet should be vacuumed only if it is deemed needed. Exiting the building. 1. Perform cleaning procedures. 2. Empty all trash 3. Lock side conference room door if it was opened 4. Turn off all lights. 5. Leave this completed checklist on console. 6. Arm building with CODE + AWAY. You may push the conference room door lock to lock it upon leaving. Shut barn doors and lock all locks. Return keys to their lockbox location. Reviewed by: Foundation Staff/Date Renter/Date