Contact Us

Email: office@perthbiblechurch.org
Phone: 518-533-0082
Address: 1863 County Hwy 107
Amsterdam, NY 12010
Office Hours: Monday-Friday 8:00-3:30

Facilities Usage Form

Submitting this form does not guarantee use of PBC's facilties. We will contact you with the team's response. Thank you!

First Name

Last Name

Phone Number

Is this for personal or group sport use?

Are you a member of PBC?

Yes

Is this for a one-time use or re-occurring?

What dates and times are you looking to use the facility?

What is the purpose for using the facility?

Which area of the facilities would you like to use?

Gymnasium

Outdoor Pavillion

Insurance Provider Name

Insurance Policy Number

Full Name of Person/Organization Under the Insurance Policy

Signature

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Facilities Usage Form

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