Use of Facility Request Name* First Last Email*Note: It is not a problem if you do NOT have your own email address. If this is the case, when prompted, please provide "office@lbac.org" in order to complete this form submission. Since we cannot send you a confirmation email from this request, you may call the church office at 562.420.1478 for verification. Enter Email Confirm Email Phone*Name or type of event (i.e. Wedding, Bible Study, Leadership Meeting)* Number of people expected to attend*Approximate number Address* Street Address Address Line 2 City ZIP Code Name of person responsible for event*Note: This person MUST attend the event (from set-up through tear-down) First Last Phone number of above person*Date of event*First choice MM slash DD slash YYYY Alternate dateIf requested date is not available MM slash DD slash YYYY Is this a recurring event?* Yes No What frequency will this event occur?*(i.e. monthly, weekly, bi-monthly) Start time of event*Please do NOT include set-up / tear-down time : Hours Minutes AM PM AM/PM End time of event*Please do NOT include set-up / tear-down time : Hours Minutes AM PM AM/PM Will this event require additional set-up or tear-down time?* Yes No Set-up START time* : Hours Minutes AM PM AM/PM Tear-down END time* : Hours Minutes AM PM AM/PM FacilityFacilities Requested*Check as many as apply All Church Sanctuary Gym Kitchen Room(s) Other Facilities (Other):* Please be aware and prepare for all room set-up and tear-down (returning the room to its "cleared and clean" state) is the responsibility of your department. We do not have any support staff for room set-up/tear-down or mid-week cleaning.Will room use in Sanctuary or Gym require sound system/equipment?* Yes No Sound system/equipment required?Please list any and all equipment needs (i.e number of microphones, projector) Additional InformationOther notes or important informationResponsibilityBy checking this box, I am assuming full responsibility for any any damage to the the facility. I understand it is my responsibility to return the facility to its original condition; any items in the room must not be tampered with and must be returned to their original place. I take full responsibility for maintaining the cooperation of the group in attendance.* Yes, I confirm and agree with these terms Δ
