South Roanoke Baptist Association Outreach Trailer Rental Application
Please read the SRBA Outreach Trailer Policies and all other forms pertaining to the rental of the SRBA Outreach Trailer before completing this application. Policies and forms may be accessed at www.southroanoke.org.
Host Church *
Your answer
Event Description *
Your answer
Event Date *
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Event Time *
Time
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Event Location *
Your answer
How do you plan to share the Gospel at this event? *
Your answer
Event Coordinator/Contact Person *
Your answer
Coordinator Phone Number (Cell) *
Your answer
Coordinator Email *
Your answer
Secondary Contact Person
Your answer
Secondary Contact Phone Number
Your answer
Secondary Contact Person Email
Your answer
The following information is required in order for your application to be accepted
The state of North Carolina requires training before persons can use the inflatables on the Outreach Trailers. At least one trained person must be with the inflatables at all times. It is mandatory that at least 2 people from each church participate in hands-on training. The people who complete the training must sign a document stating they have done so.

Please list the names of 2 people who will be completing or already have completed the hands-on training:
Name *
Your answer
Email *
Your answer
Name *
Your answer
Email *
Your answer
The following information is required in order for your application to be accepted
List the name of the driver who will pick up and return the outreach trailer for your event. ​Be sure to complete the Driver’s Form on our website prior to your event.
Driver's Name *
Your answer
Date and Time Trailer is to be Picked Up *
Your answer
Date and Time Trailer will be Returned *
Your answer
Untitled Title
*Dates of availability of your request will be confirmed via email.
*Checks should be made payable to the South Roanoke Baptist Association with "Outreach Trailer" written in the memo section of the check. Mail checks to South Roanoke Baptist Association, 606 Country Club Drive, Greenville, NC 27834
*The outreach trailer remains the property of the South Roanoke Baptist Association (SRBA) at all times and is available to member churches, church plants, and missions. The outreach trailer is not available for personal use.
*By signing this application, I agree to supervise the outreach trailer, its various components, and the use of the components at all times while it is in our possession. I agree to follow all equipment operation guidelines while the outreach trailer is in our possession.
*I agree to follow all safety precautions.
*I understand and acknowledge that the activity to be engaged in through our use of the outreach trailer and its components brings both known and unanticipated risks to myself, the operators, volunteers, and participants. Those risks include, but are not limited to falling, slipping, crashing, colliding, cuts, burns, etc. and could result in injury, illness, emotional distress, death, and /or property damage to myself, operators, volunteers, or our participants.
*I understand that the inflatables will not be put away wet.
*While in your possession, you may not sublease, rent, sell, loan, etc. the outreach trailer or its components to anyone.
*I voluntarily release, indemnify, hold harmless and discharge the SRBA from all liability, claims, demands, actions, or rights of actions, whether personal to me or to a third party which are related to, arise out of, or are in any way connected with our use of the outreach trailer and its components, including those allegedly attributable to negligent acts or omissions. I agree to reimburse any reasonable attorney’s fees and costs which may be incurred by the SRBA that I am borrowing from in the defense of any such liability claim, demand, action or right of action.
*I understand that the safety of the children and all participants depends on me. My personal supervision is absolutely required. As the borrower of the outreach trailer, the safety of all operators, volunteers, and participants is my responsibility.
*I understand that the SRBA strongly encourages churches to do background checks on all persons involved with the event when using the outreach trailer. This is an important responsibility of the sponsoring church to insure the safety of children and youth.
*I understand that the event onsite supervisor(s) must be trained by the SRBA and must be at the event at all times. We strongly recommend that each event have a minimum of TWO onsite leaders.

*Check the box below and include your signature after reading the entire document.

I acknowledge and certify, with my signature below, that I have had sufficient opportunity to thoroughly read this document, and all other required documents, and I understand its content and that I execute it freely, intelligently, without duress of any kind, that I am authorized as a leader in my church to make such agreement and agree to be bound by its terms. *
Required
Signature of Church Representative *
Your answer
Date *
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