Key Request Form

First Name *

Last Name *

Organisation

Address of Organisation or Individual

Contact Email Address *

Contact Phone Number *

Function Name

Rooms to be Used (Other)

Date/s of Use

I willingly accept the responsibility for holding the keys to the above mentioned room(s) at the Alice Springs Baptist Church.

Furthermore, I agree that:

The group will leave the facility clean and tidy and in the manner in which it was found.
The group will leave the facility fully secured.
The key will be returned to Church office on the day of use or the next working day as appropriate and depending on the time of use.
Under no circumstances will any member of my organisation or party known to me, duplicate the key/s.

If any of the above conditions are not met, the Alice Springs Baptist Church has the right to revoke the future use of this facility.

I have read and understood the information above and agree to the terms *

Key(s) Number Issued (Office Use Only)

Issuing Officer (Office Use Only)

Date Issued:

Receiving Officer (Office Use Only)

Key(s) Number Returned (Office Use Only)

Date Returned: