Resources for Members

Name *

First Name

Last Name

Are you an SLBA Church or Ministry? *

Yes

No

Start Date of Reservation *

MM

DD

YYYY

Pick Up Time *

Hour

Minute

Second

AM PM

End Date of Reservation *

MM

DD

YYYY

Return Time *

Hour

Minute

Second

AM PM

$50.00 per day Acknowledgment *

I understand that the Van use fee is $50.00 per day and that it must be returned washed, cleaned inside, and full of fuel.

Yes

Does your church have non-owned and hired auto liability insurance? *

Yes

No

Insurance Deductible Acknowledgment *

In the event of an accident and the SLBA is required to pay the insurance deductible (up to $500), does your church/ministry agree to reimburse the SLBA for the total deductible amount?

Yes

Driver #1 is 25 years of age or over. *

Yes

No

Has driver #1 had any violations or At Fault accidents in the last 3 – 5 years? *

Yes

No

Driver #2 is 25 years of age or over.

Yes

No

Has driver #2 had any violations or At Fault accidents in the last 3 – 5 years?

Yes

No

Cleaning & Fuel Coverage *

Before returning the SLBA van, do you agree to (1) fill the tank and (2) clean the van inside and out? (If the van needs to be cleaned by SLBA staff, then we will bill your church/ministry a $50 cleaning fee. If the van only needs to be filled with gas we will pass those fuel charges on plus a $10 convenience fee.)

YES we agree to clean and fill up the van.

NO, please bill us for fuel and cleaning charges.

I understand that it is our obligation to contact the SLBA office about 1 week prior to picking up the van to make arrangements to pick up the key! Failure to do this may result in not being able to get the van when you need it. *

I agree to call the SLBA office to make arrangements to pick up a key to the van.

Name *

First Name

Last Name

Phone *

(###)

###

####

Are you an SLBA Church or Ministry? *

Yes

No

Start Date of Reservation: *

MM

DD

YYYY

End Date of Reservation: *

MM

DD

YYYY

Pack/Return Trailer *

I agree to follow the guidelines in the Event Trailer notebook when packing the trailer. I will make sure all items are placed and secured properly.

Yes

No

Terms/Charges

I have read and agree to the terms and charges for the Event Trailer.

Yes

No

Name *

First Name

Last Name

Phone *

(###)

###

####

Are you an SLBA Church or Ministry? *

Yes

No

Start Date of Reservation: *

MM

DD

YYYY

End Date of Reservation: *

MM

DD

YYYY