District 196 Request for Facility Use
Enter Event Date *
MM
/
DD
/
YYYY
Please list additional rental date requests if more than one date (list add'l dates (including second choice), or start/end date, preferred days of the week, days to exclude, preferred location(s)
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Your group/organization name *
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Activity
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Number of participants ages 5 years and under
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Number of participants ages 6-18 years
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Number of participants ages 19-61 years
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Number of participants ages 62+ years
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School you are interested in renting a facility at:
Additional school choice(s)
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Facility type
Additional comments about facility type
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Start time (includes set up time)
Time
:
End time (includes take down time)
Time
:
Event start time
Time
:
Event end time
Time
:
Additional comments about time
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Special equipment request
Additional comments about special equipment requests
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Special instructions
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Contact name *
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Telephone *
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Email address
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Mailing address
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Preferred method of communication *
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