Dates Requested definition

Dates Requested. Hours Requested: Purpose/Event/Activity: Please indicate any request for specific rooms/space needed (i.e. furnishings, equipment, etc.): Number of attendees (please specify adults and children): Are custodian services needed: Yes No If yes, please explain: If no, please provide the full name and contact phone number for the person responsible for clean-up after your event: Contact Name: Phone Number: Will there be an admission/participation charge for attendees? Yes No AGREEMENT:

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Dates Requested. 20 Fri: Sat: Sun: Mon: Tues: Wed: Thurs:

Dates Requested. From: To: Banner Size: H: W: Exact Banner Message: See ReveRSe Side FoR AdditionAl inFoRmAtion “I have read and understand the provisions stated on the reverse side of this form” Signature: Date: Telephone: Address: Contact Person: Event Sponsor: Approved this day of , 20 By:

Examples of Dates Requested in a sentence

• Name: School: Date(s) Requested: Reason for Request: Teacher’s Signature Date Approved Superintendent’s signature Community Consolidated School District 15 ▇▇▇ ▇.

• Name of Organization: Responsible Person: Day Phone: Address: Contact Person’s Name: Day Phone: Fax: Email: Cell Phone: Organization’s Purpose: Date(s) Requested: Start Time: End Time: Frequency: One Time Only _ Weekly Monthly Mon Tue Wed Thurs Fri Sat Sun Describe IN DETAIL the type of event you will be bringing to our facility, including number of participants.

• Name: School: Date(s) Requested: Reason for Request: Teacher’s Signature Date Approved Superintendent’s signature All CCSD15 employees are expected to report to work as scheduled.

• Location Requested: Date(s) Requested : Make Cheque Payable to Century Group Lands Corporation Notes: Required Insurance Documentation Insurance: We require a copy of your insurance coverage each time you book space.

• Renter/s: Date/s Requested for: Start Time: Finish Time: Purpose of Event: Name of Caterer: N/A Special Occasion Permit Required: Yes / No (circle one) Estimated Number of Guests: I have read this Agreement and hereby covenant and agree to all the general terms and specific conditions set out and, in particular, hereby covenant and agree that I am personally responsible and obligated to pay all charges due Township of Cramahe in accordance with the conditions in Schedule A.

• Attendance I would like to use the following areas: □ auditorium and apron (area in front of main curtain) □ dressing rooms □ auditorium, stage (area behind the main curtain) □ ticket booth □ backstage area Dates Requested.

• Name of Employee: Date(s) Requested for Leave: I have read and understand the provisions of the applicable collective bargaining agreement BEA/OAPSE Local 250 and the Board of Education and certify that this request is in conformity with those provisions.

• Date/s Requested: A dditional Fees that apply to all above services and packages: Customer Name: Ph: ( ) - Email: Address: Town: State: Zip: Credit Card# (Visa, MC, Amex) Exp / Security Code I have read and agree to the contract and all terms and conditions: Customer Signature Print Name Date ▇▇▇ ▇.

• Person Requesting Phone Date Are You Employed by the District: Yes No Facilities Needed Date(s) Requested Time(s) Requested Type of Activity Number Participating Name of Eligible Group Admission Charged or Contributions Solicited.

• Name: School: Date(s) Requested: Reason for Request: Teacher’s Signature Date Approved Superintendent’s signature Community Consolidated School District 15 58▇ ▇.

More Definitions of Dates Requested

Dates Requested. Time Requested (from/to): (daily beginning & ending times) Date and Time of Performance/s: (if applicable) Detailed Description of Activity (indicate name and general topic if a speaker): ** Copies of marketing materials need to be provided to [INSERT OFFICE] prior to advertising the event! ** Please list any special needs below: Food Service: [INSERT IF YOUR FOOD SERVICE CONTRACT REQUIRES ALL CATERING THOUGH YOUR VENDOR] Room Setup (Check all that apply): Tables: How many? / Chairs: How many? / Podium: / Other: Audio/Visual: Arrangements will be made through the Media Center. Contact information will be given when reservation is confirmed. Safety and Security: Determination of security and insurance requirements will be solely at the discretion of the Institution. OTHER: APPROVED DENIED Date: Comments:

Dates Requested. Times Requested: Expected Attendance: Admission Charged: Y / N Amount: Field Lights: Y / N Field #: Total Estimated Time: Additional Vendor Name(s): Vendor’s Contact Information: In making this application, I and/or my organization understand all fees, rules, and regulations of the ▇▇▇ County Commission that apply to this form, and I/we shall abide by all rules and regulations set forth. I/we assume all financial responsibilities for any damages that I/we cause to the facilities and/or property of ▇▇▇ County. I/we further acknowledge that using these facilities may involve risks and dangers, and I/we shall not hold any person and/or the ▇▇▇ County Commission, ▇▇▇ County Commissioners, ▇▇▇ County Parks Manager, their agents, servants, employees, or representatives liable for any accidents and/or injuries that may occur while using these facilities or equipment. I/we also understand that ALL outside vendors engaging in commerce must be approved by the ▇▇▇ County Commission prior to the scheduled event and acknowledge if the Vendor fails to comply, I/we are subject to having our event terminated immediately. Signature of Applicant/Renter Date ▇▇▇ County Parks Manager

Dates Requested. From: To: Banner Size: H: W: Exact Banner Message:

Dates Requested. Start End: Day(s): MON TUE WED TH FRI SAT SUN Program Time(s): _ am/pm to am/pm