Facility & Parking Use Authorization

Request Use of Lodge Facilities or Parking

Clemmons Masonic Lodge No. 755 · 6210 Stadium Drive, Clemmons, NC 27012

  1. 1

    Request

  2. 2

    Document & Insurance Review

  3. 3

    Written Decision

Submitting a request does NOT grant permission to use the property. No verbal approval or scheduling assurance is valid. Use is prohibited until the Lodge issues written authorization after reviewing required documents and insurance.

What may be required

Documents

  1. 1

    Signed use agreement

    Issued by the Lodge after review. Both the applicant and an authorized Lodge representative must sign before any use.

  2. 2

    Certificate of Insurance (COI)

    Shows general or event liability coverage relevant to your activity, with the named insured matching the applicant, valid dates covering your event, and limits acceptable to the Lodge.

  3. 3

    Additional-insured endorsement

    When required, an endorsement naming the legal entity that owns or controls the Lodge property as an additional insured — not merely as certificate holder. A COI alone does not bind the insurer; the Lodge verifies the endorsement itself.

  4. 4

    Activity-specific items

    Depending on your use: permits, vendor certificates of insurance, a traffic or parking plan, a site map, or an event itinerary.

General liability minimum: Awaiting Lodge confirmation
Additional insured (legal entity): Awaiting Lodge confirmation
Fees / deposit: None set — any fee or deposit will be stated in writing by the Lodge.

Draft policy · pending Lodge & counsel approval

Conditions of use

  • No unsupervised access to the building or grounds unless specifically authorized in writing.
  • Permission may not be transferred, assigned or sublicensed to any other person or group.
  • Keep all exits, fire lanes, walkways and accessible parking clear at all times.
  • Use only the approved areas, on the approved dates and during the approved times.
  • No alcohol, open flames, tents or canopies, or vendor sales unless specifically approved in writing.
  • The organizer is responsible for setup, cleanup, any damage, the conduct of participants and parking control.
  • Comply with all applicable laws and with any emergency directive from Lodge representatives or public officials.
  • Obtain any permits required for the activity (for example fire, health, event or traffic permits).
  • No changes to the approved use without new written approval from the Lodge.

Application

Apply for review

About 10 minutes. Parking-only requests skip building questions; building-only requests skip parking questions.

Progress (except signatures and files) is saved on this device only so you can return after a refresh. Clear it any time by submitting or using “Start over”.

A. Who is applying

What are you requesting? *

Privacy

We collect only what is needed to review your request. Information and documents are stored securely and are visible only to authorized Lodge officers; they are never shown publicly or shared with other applicants. Retention period awaiting Lodge confirmation. Questions: (336) 766-9085.