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Facilities Reservation Form

First Name

Last Name

Email Address

Phone Number


Time of Day



Date(s) of Reservation

*Please mark dates by (start date mm/dd/year - end date mm/dd/year)

Name of Church Member or Regular Attender Present


Access to Building

 I have access

 I will need access

Estimated number of people involved

Equipment Needed (please select all that apply)



 Sound System

 Coffee Pot(s)


Facilities Needed (please select all that apply)

 Fellowship Hall






  Please read our Facility Use Policy.

USE GUIDELINES. Signature of this form indicates acceptance of all applicable fees and guidelines.

 The person/organization requesting the use of Church facilities hereby absolves the church, its pastors, leadership, members, or people of any liability for personal injury to any individual resulting from the use of the church facilities and agrees to be responsible for any property damage that results during the use of the facilities.  Please report any damage to the church office promptly.

The group or individual using the facility is responsible for set up, clean up, and return to normal set up of the facility.


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