Activity Request Form

For ROLCM Internal Use Only

Please provide as much information as possible. The form will be sent to the administrative staff at Rivers of Life Church Ministries upon submission. For questions regarding the status of your request, please call the church office at (813) 643-3848.

Date of Request*
MM slash DD slash YYYY
Requestor Name*
First Last
Requestor Phone Number*
Requestor Email
Ministry*
Ministry (Manual Entry)

Please enter the name of the appropriate ministry or group.
Name of Activity / Event*
Date of Activity / Event*
MM slash DD slash YYYY
Actual Activity / Event Start Time*

: Hours

Minutes

AM/PM
Actual Activity / Event End Time*

: Hours

Minutes

AM/PM
Reservation Start Time*

: Hours

Minutes

AM/PM

Please allow for set up, break down, and clean up.
Reservation End Time*

: Hours

Minutes

AM/PM

Please allow for set up, break down, and clean up.
Requested Room*
Requested Room (Manual Entry)

Please enter all requested rooms.
Activity Description*
Please provide details for the requested activity or event.
Additional Requirements
Please provide information on additional requirements needed to support this activity or event. These may include items such as tables, chairs, sound equipment (if available), etc.
Acknowledgement*
I acknowledge the cleaning policy for activities and/or events.
I understand that I am responsible for cleaning up after my activity/event.
(Note: Cleaning supplies are available in the storage room in the hallway.)

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