Overnight Building Use Request

Date of Request*
MM slash DD slash YYYY
Name of Organization/Individual*
Contact Person*
First Last
Address
Street Address City State / Province / Region ZIP / Postal Code
Email*
Phone
Purpose/Mission of Group/Individual
Number of Male Overnight Guests

** Please note if they are under the age of 18
Number of Female Overnight Guests

** Please note if they are under the age of 18
Total Number of Overnight Guests
Requested Check In Date*
MM slash DD slash YYYY
Requested Check In Time

: Hours

Minutes
Requested Check Out Date*
MM slash DD slash YYYY
Requested Check Out Time

: Hours

Minutes
Will you require daytime use of any space(s)?
- Yes
- No
Spaces Requested*
- Fellowship Hall (meals/activities)
- Classroom Space (sleeping quarters/sleeping bags)
- Showers
- Other
Other Information