Today's Date *

MM

DD

YYYY

Contact Person

First Name

Last Name

Phone Number *

(###)

###

####

Churchwide Event? *

Yes

No

Ongoing Request? *

Yes

No

Location *

Auditorium

Educational Center

Splashtown

Church Parking Lot

Set-Up, Take-Down and Cleaning *

Setting up, taking down and cleaning the facility after the event is the responsibility of the requesting group or ministry.

I understand

I don't understand

Kitchen Requested *

Kitchen clean-up is the responsibility of the requesting group/individual.

Yes

No

Childcare Needed? *

Have you secured approved childcare in Splash through Jessica Osborne, Children’s Ministry Director?

Yes

No

Is the Worship and Production Ministry needed?

Please check all production items that your event will need.

Audio

Lighting

Projection Slides and Screens

Video Camera

Is the Emergency Response Team Ministry (ERT) Needed? *

Yes

No