South Bay Community Church

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BUS REQUEST FORM

* Required

First Name *

Last Name *

Email Address

Address Line 1 * Address Line 2
City *	State *	Zip Code *

TODAY'S DATE
NAME OF PERSON IN CHARGE
PHONE NUMBER FOR PERSON IN CHARGE
MINISTRY
NAME OF SERVANT LEADER
GROUP NAME & ACTIVITY (Please be specific.)
NO. OF PASSENGERS
EQUIPMENT TO BE HAULED
DESTINATION (Please be specific.)
DATE OF DEPARTURE
TIME OF DEPARTURE
DATE OF RETURN
TIME OF RETURN
TOTAL # OF ADULTS (# of Males; # of Females)
TOTAL # OF CHILDREN/YOUTH (# of Males; # of Females)
SPECIAL INSTRUCTIONS

A 10% NON-REFUNDABLE ADMINISTRATIVE FEE IS DUE UPON APPROVAL OF TRIP.

BALANCE MUST BE PAID ONE (1) WEEK BEFORE SCHEDULED TRIP. NO EXCEPTIONS!!