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LifeSpring Assembly of God

951-683-6081
    
1224 Main Street
Riverside, CA  92501
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FACILITY REQUEST
PLEASE NOTE:



NO ALCOHOL - NO INAPPROPRIATE DANCING - NO INAPPROPRIATE MUSIC
NO RED PUNCH - NO SMOKING - NO MOVING TABLES
(Office will contact department leader for further approval if needed.)
Date of Request*
Department*
Dept. Leader*
Person Requesting*
Telephone Number
(include area code)*
Email Address*
ROOM, DATE & TIME INFORMATION
Room Needed*
Alternate Room
Date(s) Needed*
thru
Time Frame
(include AM or PM)*
thru
(include AM or PM)*
DETAILS
Is this recurring?*
If yes, please complete the following:
 WEEKLY
on which day(s)
of the week?
 Sunday
 Monday
 Tuesday
 Wednesday
 Thursday
 Friday
 Saturday
or
 MONTHLY
on which day(s)
of the week?

 Sunday
 Monday
 Tuesday
 Wednesday
 Thursday
 Friday
 Saturday
Which week(s)
of the month?
 1st week
 2nd week
 3rd week
 4th week
 5th week
or
 MONTHLY
On what date
of every month?
or
 OTHER:
SET-UP INFORMATION
Set-up Instructions
Equipment Needed
Cost Breakdown (if any)
FOR OFFICE USE ONLY
Church Calendar
Senior Pastor
REMINDER:
NO ALCOHOL - NO INAPPROPRIATE DANCING - NO INAPPROPRIATE MUSIC - NO RED PUNCH - NO SMOKING - NO MOVING TABLES


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