Name *

First Name

Last Name

Phone *

(###)

###

####

Date of Event *

MM

DD

YYYY

Start Time *

Please include time for set up and clean up if required.

Hour

Minute

Second

AM PM

End Time *

Please include time for set up and clean up if required.

Hour

Minute

Second

AM PM

Type of Event *

Wedding

Funeral/Memorial

Concert

Meeting

Service

Fundraiser

Other

Requested Room *

Sanctuary

Haven (basement)

Classroom(s)

Lobby

Resource Room

Blue Room

Other

Any other services requested *

Additional fees may apply. Availability and cost will be arranged with each respective department leader.

Pastor(s)

Live Music

Singer(s)

Hospitality (or use of kitchen)

Ushers

Security

Other

Any graphic requests needed? *

This could be a graphic, flyer, video or announcement. (If yes is selected, a design request form will be sent to be filled)

Yes

No