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Facilities Use/Setup

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The Church of St. Patrick

137 Moseman Road ♦ Yorktown Heights, NY ♦ 10598-4806
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- DAY and DATE of Function: REQUIRED Please fill out this field. Please enter valid data.
- All event requests tentative until approved
- Insurance Certificate Required: REQUIRED Yes No Please fill out this field.
- IT IS UNDERSTOOD THAT:
  
  All Parish Center Hall, Family Education Center & Gym events MUST be completed no later than 9:00PM.
  
  All Stone Church and Lower Level of Stone Church events MUST be completed no later than 8:00PM.
  
  All lights must be turned out, bathroom checked, windows closed and door locked before leaving premises.
  
  Floor must be swept and all litter picked up.
  
  All props, equipment, posters, decorations, etc., must be removed.
  
  Please DO NOT TAPE decorations to the walls.
  
  If the event is cancelled, please notify the parish secretary.
  
  All speakers must be approved by the Pastor before being invited.
  
  An annual donation to defray costs would be appreciated.
- Group/Organization: REQUIRED Please fill out this field. Please enter valid data.
- Activity planned: REQUIRED Please fill out this field. Please enter valid data.
- Event Date: REQUIRED Please fill out this field. Please enter a date.
- Event Start Time: REQUIRED Please fill out this field. Please enter valid data.
- Event End Time: REQUIRED Please fill out this field. Please enter valid data.
- Set Up Date: REQUIRED Please fill out this field. Please enter a date.
- Set Up Start Time: REQUIRED Please fill out this field. Please enter valid data.
- Set Up EndTime: REQUIRED Please fill out this field. Please enter valid data.
- Contact Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number: REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Name of Speaker, if any: Please enter valid data.
- Facilities Requested: REQUIRED Please fill out this field. Please enter valid data.
- Custodial Requirements (number of tables, chairs, etc.): REQUIRED Please fill out this field.
- Please email any diagram of setup to: [email protected].
- Please type name in below to sign this form.: REQUIRED Please fill out this field. Please enter valid data.
- Signing Date: REQUIRED Please fill out this field. Please enter a date.
- *This is only an application. It is not approval. You will be notified if you are approved.
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St. Patrick's Church

Serving Yorktown's Catholic COmmunity for Over 125 Years

Facilities Use/Setup