Today's Date

YYYY

Name

First Name

Last Name

Phone

(###)

###

####

Email Address

Event Title

Ministry Area

If "Other" please describe:

Onsite/Offsite

If Onsite

If your event is offsite, please skip to the next section.

Specific Room Needed

If "other" please describe

Is this a Capitol Hill Assembly ministry event?

Setup Needs?

If this is not a CHA ministry event, please note that you are responsible for setting up, tearing down and leaving the area as you found it, including restrooms.

I agree

Requested Setup Date

YYYY

Requested Setup Time

Requested Teardown Date

YYYY

Requested Teardown Time

Event Start Date

YYYY

Event Start Time

Event End Date

YYYY

Event End Time

Time doors need to be unlocked

Time doors need to be locked

Event Details

Is this a one time event?

If no: Recurrence?

If other, please explain

Additional Details

Do you need a facility key?

Is sound/media tech required?

If yes, describe your media needs

Do you need an announcement in the bulletin?

(Note: Your event request must be submitted at least 2 weeks prior to the event in order to be announced)

If yes, please list information for the bulletin:

Do You Need Social Media Posting?

Please explain what content you want posted and where (Facebook, IG, or both)

Do you need a sign up sheet at the Information Center?

Approximate cost of the event

Are Funds needed?

If yes, amount of funds requested

Approximate number of people expected

Is childcare needed?

If yes, Number of Children Birth-Kindergarten

Number of Children 1st-6th grade

Church van required?

(Must be approved)

If yes, vans needed?

Van 1 (15 passenger)

Van 2 (15 passenger)

Van 3 (12 passenger)

Driver's statement

For insurance liability purposes, all people desiring to drive a vehicle for Capitol Hill Assembly must be on the approved drivers list in the church office and must have an MVR background check conducted.

I understand

Destination

Destination Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of key pickup

YYYY

Date of key return

YYYY

Driver #1 Name

Driver #2 Name

Driver #3 Name

Policy Agreement

(By typing your whole name, you certify that you will be the accountable person for the event listed above. In addition, you certify that you have read the church policies concerning church events and agree to comply with them)

I understand

Name

First Name

Last Name