Facility Rental Application

Date of Application

MM

DD

YYYY

Contact Person *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Is this a Registered Charity?

Yes

No

Date of Event

MM

DD

YYYY

Will there be catering?

Yes

No

Will you require tech support? (Select all that may apply)

Sound

Video

Lighting

No

Which rooms would you like to book? (Select all that may apply)

Auditorium

Classroom #1

Classroom #2

Classroom #3

Community Room

Fireside Room

Gymnasium

Kitchen

Lounge

Lobby

Three Café

Upper Room

Will you require tablecloths?

Yes

No

Chair configuration

Chairs in rows

Chairs around tables

Declaration of Intent

Note: 1. A $50 fee will be applied for each 1⁄2 hour portion beyond the agreed Exit Facility time that the facilities are not vacated. 2. Contact person will be requested to supply stage plot, room layouts, and/or set-up instructions for all rooms at a later date. 3. Seating capacities and cost breakdown for rooms will be supplied after initial application for facility rental is submitted. I hereby make application to Life Church to rent above named facilities and equipment, with specified personnel and services, and I agree to the terms and conditions set out in the Life Church Facility Rental Policy.

Agree