Requested Event Date *

MM

DD

YYYY

Setup time (min. 1 hour before event start) *

Hour

Minute

Second

AM PM

Event Begin Time *

Hour

Minute

Second

AM PM

Event End Time *

Hour

Minute

Second

AM PM

Cleanup End Time (min. 1 hour after event end) *

Hour

Minute

Second

AM PM

Name of Person Requesting Event *

First Name

Last Name

Phone *

(###)

###

####

Area(s) Needed for Event *

Foyer/Kitchen

Auditorium

Library

General Classroom

Training Room

Pavilion

I UNDERSTAND IT IS MY RESPONSIBILITY TO CLEAN UP ALL AREAS USED AT THE CONCLUSION OF THE EVENT. *

Yes

I UNDERSTAND MY RESPONSIBILITIES AND OBLIGATIONS IN USING THE FACILITIES LOCATED AT 1500 LANCASTER ROAD, RICHMOND, KENTUCKY 40475 AS SET OUT IN THE FACILITIES USE GUIDELINES, LINKED BELOW (CLICK BUTTON TO OPEN GUIDELINES DOCUMENT IN A NEW TAB). BY CLICKING "YES" BELOW, I ACKNOWLEDGE AND AGREE TO ADHERE TO THE BUILDING USE GUIDELINES OF THE RICHMOND CHURCH OF CHRIST LOCATED AT 1500 LANCASTER ROAD, RICHMOND, KENTUCKY, 40475. I UNDERSTAND THAT BY CLICKING "YES," I AM APPLYING MY DIGITAL SIGNATURE TO THIS FORM. *

Yes