FAMILY LIFE CENTER USE CHECKLIST

PARISHIONER/ORGANIZATION__________________________________________
ADDRESS_______________________________________________________________
PHONE NUMBER_____________________________
ACKNOWLEDGE RULES & REGULATIONS______________

DAMAGE/CLEANING DEPOSIT:
DAMAGE DEPOSIT ____________________CHECK#____________
CLEANING FEE _________________CHECK#________________
-Damage deposit $750.00. Cleaning fee Grand Hall & Kitchen $350.00, Grand 
 Hall only $200.00

INSURANCE:
COPY OF COMPLETED FORM____________
PROOF OF PAYMENT____________________(attach)

FAMILIARIZATION TOUR OF FACILITY________________
KEY CHECKOUT__________ KEY RETURN__________

POST USE INSPECTION DISCREPENCIES ________________________________
__________________________________________________________________________
DEPOSIT RETURN (if applicable)____________________