Building Request

Name
First Last
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Purpose for using the building (details please):
Date(s) you request use of the building:
MM slash DD slash YYYY
Set-Up Start Time

: Hours

Minutes
Clean-Up End Time

: Hours

Minutes
Event Start Time

: Hours

Minutes
Event End Time

: Hours

Minutes
Estimated number in attendance
Area of building or grounds you wish to use
- Family Center/Gym Area
- Kitchen
- Sanctuary
- Classrooms
- Grounds
- Other
If using kitchen, please indicate in what way the kitchen will be used
Contact Lynn Cowperthwaite at least 1 week prior to your event for additional kitchen information. (610-999-0477 or Raregold@aol.com)
If classrooms are needed, indicate how many
Do you need to use any equipment?
If so, please specify:
Do you have a key to the buiding?
If not contact the church office at least 1 week prior to your event to insure the doors will be opened. The office phone number is 610-269-8651
* Remember, your party is ONLY permitted to use the designated area(s) you have requested. Proof of Insurance (must be supplied to the church 1 month ahead of time of use - if required).