Westgate Church of Christ

Van Reservation Form

Date: *

Name: *

Phone #: *

Number of Vans Needed: *

Requested Start Date:

Requested End Date: *

Requested Time: *

Organization Using Van: *

Reason for Use:

Covered by Insurance? * Yes No

**If you are not covered by our insurance, then you will need to provide written proof of insurance before permissions to use our vans will be given.**

**Westgate Church of Christ is not responsible for gas unless it is a church sponsored event.**

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