Memorial Service Request Form

Introduction

First of all, let us offer our sincerest condolences for the loss of your loved one. Dealing with the death of someone close to us can be a very difficult and trying time in any person's life, so our hearts go out to you. We take seriously our calling as ministers of the gospel to “weep with those who weep” and assist those in time of need (Rom. 12:9-18).

Here at Canby Christian Church we make our facilities available for the use of funeral services primarily to our members and secondarily to those within our greater community at the express discretion of the Pastors and Elders. For this reason, we ask everyone who wishes to have a memorial service at our church complete this request form and meet with a pastor or someone assigned by our pastoral staff to determine if and how we can accommodate you in this difficult time. In addition, memorial services are performed for an affordable fee to cover the cost of staffing and facilities usage. This fee may be waived at the discretion of church leaders. Please be sure to indicate if you would like our pastoral staff to consider waiving the cost in the form below, and we will notify you of the cost at the time of your planning meeting.

General Information

Primary Contact Person's Information

First Name

Last Name

Phone

(###)

###

####

Information Regarding the Deceased

Name of the Deceased

First Name

Last Name

Requested Date of Use

YYYY

Requested Time of Entry

Hour

Minute

Second

Requested Time of Exit

Hour

Minute

Second

Requested Officiating Pastor

Outside Officiant Request

If you are using an officiant who is not a pastor of CCC, please explain who this person is. Please note, outside officiants must be approved by the Lead Pastor.

Estimated Attendance

Will you need access to audio/visual equipment?

Please note that if you need use of the church's audio/visual equipment a technician will need to be present, and may need to be compensated for their work.

Yes

Musician Request

If you would like live music please explain who you would like to perform, and what will be needed for the performance. Please note that all musicians must be approved by the officiating pastor.

Reception Request

If you would like us to host a small reception please explain the details of the reception including how many tables, seats, will food be served and what kind, what room in the building or outside would you prefer to use, etc. Please note The church building has limited space and therefore may only be able to accommodate small receptions with limitations. All receptions will need to be reviewed and approved by the overseeing officiant and the office manager.

Please provide any additional information if needed: