Bottle Reservation Form

Baby Bottle Reservation

Simply fill out the form below to reserve baby bottles for your church! If you have any questions, please don't hesitate to ask. Our office is open Monday-Thursday 10am-5pm. 573.874.3561

Bottle Reservation Form

* Indicates required field

Primary Contact Name *

Church Name *

Contact's Phone Number *

Contact's Email *

Church Address *

Line 1

Line 2

City

State

Zip Code

Country

Church Phone Number *

BABY BOTTLES

Number of Bottles Requested *

Boomerang Start Date Requested *

Boomerang End Date *

Our church would also like to request: *

My Life Clinic General Information A representative to speak during a service Campaign information for your church bulletin/projection screens

BOTTLE PICK UP AND RETURN

When the bottles are picked up, we request that you check the total and sign that you received the correct number. When you return the bottles, please plan on allowing a few minutes for us to get a count of the total. If there are any outstanding bottles, we will give you a slip with the number of bottles missing, then we will check back with you in a few weeks to see if you were able to locate them. We appreciate your effort to collect all the bottles borrowed to help curb our expenses, as they cost Life Network approximately $1.50 each to replace. Thanks again for your participation!

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