Block Party Trailer Application
*A $200 (refundable) deposit and $50 (non refundable) fee must accompany this application.
Make checks payable to Tri County Baptist Association, PO Box 370, Nixa, MO 65714
Requested Date of Use *
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Time
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Return Date *
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Time
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Name of Church *
Your answer
Pastor *
Your answer
Mailing Address *
Your answer
City *
Your answer
State
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
Purpose of Use *
Your answer
Person Responsible for the Trailer *
Your answer
Email Address to Confirm *
Your answer
Position
Your answer
Phone:Office
Your answer
Home
Your answer
Cell *
Your answer
We, the undersigned, make application for scheduling the use of the trailer with the assurance that we assume responsibility for complying with the guidelines and for use of the trailer. *
Pastor's Approval
Today's Date *
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Person Responsible for Trailer-(Typed name authorizing as signature) *
Your answer
Submit
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