FLC Facility Request Form
Miamisburg Assembly of God's Family Life Center is currently available to the church family only.
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First Name *
Last Name *
Group Name (if applicable)
Phone *
Email *
Reservation Information:
Please fill in the information below.
Date Requested *
MM
/
DD
/
YYYY
Time Desired (please only list the start and end time for the activity) *
Time
:
Set Up Information
Set Up Date Requested *
MM
/
DD
/
YYYY
Set Up Time Requested (start) *
Time
:
Set Up Time Requested (finish) *
Time
:
Tear Down Time Requested (start) *
Time
:
Tear Down Time Requested (finish) *
Time
:
Areas you would like to use *
Required
Approximate number of adults (18+) *
Approximate number of children (under 19 years of age) *
Message
Submit
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