Filling out and signing this form means that you have read and agree with the Union City Christian Church Facilities Usage Agreement.

Group name:

Name of person responsible for group using building:

Phone number:

Building(s) to be used:             Fellowship Hall                                 Auditorium

Date building(s) to be used:

Time building(s) will be used:

          From   AM PM        Until AM PM

I would like to have the church janitor clean the building(s) at a cost of $75 per building:

            Please check either "yes" or "no"        YES         NO

        Day of the week to be used:

                          Monday     Tuesday     Wednesday      Thursday     Friday     Saturday

        We would like to use the facility:       Every week           Every Month

                        If every Month, check which week of the month it will be used:

                                1st       2nd        3rd        4th        5th        last

        When do you plan to begin using the facility:    

        Time of day the facility is to be used: 

            From   AM PM       Until  AM PM

If you have any questions about this form, please contact the church office any weekday.

You may mail the form to the church office, along with your deposit and cleaning fee, if you are using our janitor. However, the form must be in the office at least two weeks prior to the date being requested to use the building(s).