REQUEST FOR USE FORM

St. Peter's Lutheran Church
Request for Use of Son & Sand Retreat Center Facilities

Church Making Request *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone # *

Name of Group to Use Facility *

Purpose of Retreat *

Person in Charge of Retreat *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Cell Phone # *

Phone Number *

PARTICIPANTS

Youth (ages 7-17 years old): *

Male *

Female *

Adults (ages 18 or older): *

Male *

Female *

TOTAL PARTICIPANTS: *

Male *

Female *

Dates requested: From *

To *

2nd Choice: From *

To *

Estimated Arrival Time: *

Departure Time: *

We will assure the facility is cleaned, all trash removed, and that all equipment is returned to its proper location. We understand that St. Peter's Lutheran Church will not be responsible in case of injury or illness to any participant while on the premises.

A certificate of proof of liability insurance must be submitted prior to your visit.

We agree to abide by the rules and regulations set forth by St. Peter's Lutheran Church Son & Sand Retreat Center.

Signature: *

Title: *

Date: *

Submit

St. Peter's Lutheran ChurchRequest for Use of Son & Sand Retreat Center Facilities

St. Peter's Lutheran Church
Request for Use of Son & Sand Retreat Center Facilities