Crossroads UMC, IL: Forms Page: Room Request Form

Room Request Form

Crossroads United Methodist Church
                 P.O. Box 299
          1420 North Main Street
           Washington, IL 61571
           Phone: 309-444-2381

* Required

Errors

Date of Event **Note: No meetings or events will be scheduled between December 26th and January 1st.** *

Event Description *

First Name *

Last Name *

Phone number *
( ) - ext.

Alternate Phone Number
( ) - ext.

Email Address *

Time event begins *

*

Time event ends *

*

I need access from *

*

to *

*

Is this a recurring event? *

yes

no

If yes, how often does the event occur?

End date (for recurring events)

Number of people expected *

Room(s) Requested *

Resources needed: *

Do you have any AV/Sound equipment needs? *

Is child care needed? Note: Child care is provided at no cost on Thursday and Sunday nights only. If child care is needed on any other night, the cost is $8.50 per hour for each child care provider. *

If yes, please list the number of children and their ages.

Do you have any other special set-up instructions?

I have read the Church Building Use Policy *

I have read the Crossroads UMC Child Protection Policy (if applicable)