FACILITY USE REQUEST FORM
Messiah Missionary Baptist Church
513 Henry S.E.
616-458-2651
Please submit completed form to the Building Superintendent two weeks or more in advance of date requested.
1. Date: 2/24/2021
(Group or individual requesting use)
2. Address: Telephone (reqd):
3. Date(s) Requested: Start date: End date:
4. Time of day: Begin: End:
5. Facilitator:
6. Consultation (Required for items 7, 8 & 9) : Date Time
7. Facilities needed (please check all that you plan to use):
Fellowship Hall Set-up Tables and chairs
Kitchen Library
Classroom(s) How many? Set-up Classrooms
8. Equipment needed: Where needed
TV/VCR/DVD BOOM BOX OVERHEAD PROJECTOR/LED
POWERPOINT SOUND SYSTEM COFFEE POT(S)
9. Service needed: SECURITY CUSTODIAN
Use Guidelines. Signature of this form indicates acceptance of all applicable fees and guidelines.
Please explain activity to be held:
Estimated number of people:
The person/organization requesting the use of Church facilities hereby absolves the church, its pastors, leadership, members, or people of any liability for personal injury to any individual resulting from the use of the church facilities and agrees to be responsible for any property damage that results during the use of the facilities. Please report any damage to the church office promptly. The group or individual using the facility is responsible for returning the area(s) to the same condition as before use.
Signature of Responsible Party Date