Shared Facility Use

Host Name

Organization Name (If applicable)

Phone

This address will receive a confirmation email

Address

Date of Event (Not available on Sundays)

Time of Event

Time Period for Reservation (Set-Up to Clean Up -Must Be Continuous)

Purpose of Event

Number of Guests

Preferred Location (Auditorium, Dining Room, etc)

Preferred 4 digit key code for access for the event

I have read the FCC Bristol CT Guidelines & Agreement for Use of Facilities and agree to the terms and conditions.

Yes No

Provided the FCC Facility is left in clean and good order, I would prefer for my deposit check to be:

Shredded I will pick up

The certificate of insurance naming the First Congregational Church will be

Mailed to the church, 31 Maple Street, Bristol, CT Emailed to the church, Admin@FirstChurchBristol.org

Electronic Signature

Date signed

Description

To submit an application to use FCC's facilities, please read "FCC's Rules & Procedures for Use of Facilities" and then fill out this form. Payments can be made electronically or by check.

Shared Facility Use

Description

Please Fix the Following