Facilities Use/Event Form

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Please complete this form for any room or space requests at Rivera United Methodist Church.

Email*

Group/Committee/Organization Name*

Contact name of person responsible for group?*

Phone number of person responsible for group*

Name of event?*

Expected number attending?*

Date of event (recurring information next box)*

Month

Day

Year

If recurring event, please specify the frequency (ie, the second Tuesday of every month: every Monday in April Thursdays May 1st through May 29th)*

Setup time for event*

Time

:HoursMinutes

Starting time of event*

Time

:HoursMinutes

Ending time of event*

Time

:HoursMinutes

Breakdown/Cleanup time of event*

Time

:HoursMinutes

Requested space/location. Check all that apply.*

Handicap spot/spots

Front Lot

Field

Back Lot

Sanctuary

Narthex

Fellowship Hall

Conference Room

Kitchen

Bathrooms

Nursery

Children's Room

Youth Room

Upstairs Room 26

Upstairs Room 27

Upstairs Room 28

What equipment will you need for this event? Check all that apply.*

Tables

Chairs

Microphone

Projector

Screen

Sound System

TV/Monitor

Podium

Kitchen Access

Other

Will a Breeze registration form be needed?*

Yes

Any graphics needed?*

Yes

Description of event?*

What date should the announcement begin?*

Where should the event announcement be distributed? Check all that apply.*

Weekly E-Letter

Announcement slides during Worship on Sunday mornings

Church calendar

No announcement needed

Other

Additional description of the event/meeting, which will be included in the publications checked above.*

1-727-527-6466

175 62nd Ave N

St. Petersburg, FL 33702

www.rivieraumc.org

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