Church Use Request

Name

This address will receive a confirmation email

Phone

Address

Name of Event

Date of Event

Time of Event

Briefly describe the event and when you will need access to the church for set-up, tear-down and clean-up

Rooms Requested

Auditorium (75-200 People) Kitchen Basement Room 206 (Meeting space suitable for 20-70 people) Room 201 (10-25 people, located by kitchen) Other

Services Requested Use of projector Use of TV Use of Audio Equipment Other

Number of attendees expected?

Person Responsible for Clean-Up (if unknown please state as such)

Person responsible for locking up (if unknown please state as such)

Church Member overseeing the event (If unknown please state as such)

NOTE: Each group is responsible for cleaning of areas used and trash removal.

NOTE: Each group is responsible for set –up and tear down of tables and chairs. Any tables or chairs moved should be returned to original positions.

NOTE: If you are requesting use of the kitchen you are responsible for the cutlery, dishes and cups for your specific event.

NOTE: Our entire campus is tobacco, alcohol and drug free. Thank you in advance for your respect in this area.

NOTE: In order to serve you we require all Facility Usage Requests be turned in no later than 10 days prior to the Date of the Event. The completed form, can be turned into the Pastor or deacons, or mailed to CrossPoint Church | PO Box 266 | Jasper, IN 47547

I agree to follow the above guidelines and make sure the church is cleaned at the conclusion of the event.

Yes

Church Use Request

Description

Please Fix the Following