TENT

Block Party Equipment Request Form

(July 2, 2009)

Church Name: ________________________________________________________

Address: _________________________________________________________

Contact Person: _________________________________________________________

Phone: (H) _________________ (W) _________________(Cell) __________________

E-Mail: __________________________________________

Request Dates

Pick-up Date: _________________ Event Start Time: __________

Event Dates: __________________ Event End Time: ___________

*Inflatable Inspection Date: _______________ (This is to be scheduled and completed prior to event opening day)

Event Location address and Driving Directions: ___________________________________________________________________________________________________

_________________________________________________________________________________________________.

Return Date: ___________________

Insurance Liability Form Enclosed: ________________

(Liability Insurance for the church is required for use of inflatable)

Deposit Enclosed ($250.00): _______________

(Please make checks payable to: Keystone Baptist Association, 837 N. U.S. Hwy 15, Dillsburg, PA 17019)

$100.00 for equipment insurance, maintenance, and supplies will be charged. $150.00 of deposit will be returned if all items are repacked and cleaned according to the instruction sheet and returned in good condition when the evaluation form is turned in.

Items Included:

Block Party Games

Concession Equipment

Large Inflatable

Please be advised that you will need a truck/car with 2” trailer hitch and towing capability in order to tow block party trailer.

*The inflatable must be inspected by a certified state inspector prior to use. There are several individuals in our association who are certified and must be scheduled for the inspection two (2) weeks in advance. Short-notice scheduling will result in the need for your organization to contact the State of PA to obtain an inspector. Their cost is $150.00 for each event. They can be contacted at 717-787-2291.

I understand that our church is responsible for reimbursing the mileage to the Certified Inflatable Inspector that is not KBA staff at $.45/mile each time to inspect our set up. Checks will be made payable to the Inspector and paid within 2 weeks of the event.

I hereby acknowledged that I have read the requirements for reserving the block party trailer which includes the requirements for the inflatable to be inspected by a certified State PA inspector and mileage reimbursement to the inspectors.

______________________________ ______________

Requesting Individual Date

_______________________________ _______________

Pastor Date

TENT GUIDELINES

1. The rental deposit for each event is $250.00. $200 of the deposit is refundable upon return and inspection of the tent. The inspection will be conducted by the Keystone Baptist Association (KBA).

2. I understand that we assume full responsibility for any damages to the tent or trailer up to the full amount of the deposit. If there are no damages to the tent or trailer upon return, I understand $200 of the deposit will be returned.

3. I understand that $200 of the deposit will not be returned until the Tent Evaluation Form is completed and returned to the KBA site. $50 will be retained.

4. I understand that while the tent and trailer are in our possession that they can not be rented, transferred to or loaned out to any individual, group, church, or association.

5. I understand that the trailer will be stored in a safe location and that the doors will be fully secured at all times.

6. I understand that the trailer will be returned on the date specified to the location identified by the KBA.

7. I understand that the tent will remain with the trailer at all times. Any use of the trailer for anything other than for transporting and storing the tent, must be pre-approved by the KBA.

8. I understand that the tent must be erected in a safe manner. Instructions for erecting the tent are located inside the trailer. I understand that all parts for erecting the tent must be accounted for after the tent is used and placed back in the trailer.

9. I understand that the tent must be cleaned according to the instructions inside the trailer before being placed back into the trailer.

10. I understand that no modifications to the tent or trailer can be made, including painting, and signage.

11. I understand that emergency repairs can be made to the tent and trailer, including repairing rips on the tent, fixing flat tires, and bulbs. All receipts for reimbursement, must accompany the Tent Evaluation Form.

12. I understand that picking up and returning the tent and trailer is the responsibility of the renting group. The appropriate trailer hitch and ball (2 inch) is required before the tent and trailer is moved.

13. I understand that the Tent Ministry is supported by the Cooperative Program Ministry of the Southern Baptist Convention & KBA.

On behalf of _____________________________ I accept the provisions of the Tent Guidelines:

Name of Association or Church

_____________________________________ ______________________

Requesting Individual Date

_____________________________________ _______________________

Pastor Date

TENT EVALUATION FORM

Please complete the Tent Evaluation Form and return immediately after your event or you will forfeit your $250.00 deposit.

Date Form Completed: __________________ Date Tent Returned: _____________________

Church/Association (Circle One):_________________________________________________

Ministerial Staff: ______________________________________________________________

Address: ___________________________________________________________________

City: ___________________________ State:_____ Email:_____________________________

Date(s) Tent Used: ____________________________________________________________

1) Was this an evangelistic event? ____Yes ___ No____. Describe the event ______________

________ ________________________________________________________________

What do you think this event accomplished? ______________________________________

________ ________________________________________________________________

2) How many people participated in this event? ________________

Were there any first-time decisions? ____Yes ____ No.

If yes, how many? ______________.

3) Was the tent inspected the day it was erected? ____Yes ____ No

Was there any damage? ____Yes ____ No.

Where was the damage located? ______________________________________________

(See the tent diagram).

4) Did you make any emergency repairs to the tent or trailer? ____ Yes ____ No.

Describe the repair work: ____________________________________________________

________ ________________________________________________________________

5) Did you clean the tent according to the instructions inside the trailer? ____ Yes ____ No.

6) Did you inspect the tent before placing it back into the trailer? ____ Yes ____ No.

Were there any damages? ____ Yes ____ No

________ ________________________________________________________________

7) Did you take any pictures of the event? ____ Yes ____ No.

Were they taken with a Digital camera? ____ Yes ____ No.

Please email copies of pictures to: Richard.kba@verizon.net .

Comments: _ ______________________________________________________________

________ ________________________________________________________________