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Athletics

DEPARTMENT OF ATHLETICS
KNELLER ATHLETIC CENTER/POOL
FACILITY REQUEST FORM
Organization Name( required):   Today's Date:  
On-Campus Group
Off-Campus Group
Contact Person (required):  
 		 Contact Phone Number (required):  
 
Room Number/Street Address:  
 		 Box Number/City, State:  
 
Contact Email (required):  
 
Date of Request (1st Choice):  
 		 Time Requested:  
 From-To
Date of Request (2nd Choice):  
 		 Time Requested:  
 From-To
Is your program profit or non-profit: Yes No
Number of participants:  
 		 Number of spectators:  
 
Approximate Number of Parking Spaces Needed  
 
Ratio of adults to youth participants:  
 

Name
of person who will be on-site during event 		 
 
Day Phone  
 		 Night Phone  
   
Cell Phone  
 
Name and phone number of your
on-site medical person (Certified Trainer, EMT, etc.):
 
Name  
 		 Phone  
 
Is there a fee charged to participants or teams? If yes how much?  
 		  
Will there be an admission charge?   If Yes, How much?:  
Will there be food, concessions, etc?  
Facility Requested
Kneller Athletic Center (Hurst Basketball Courts)
Kneller Athletic Center (Volleyball Area)
Pool
Conference Room
Locker Rooms/Showeres
Other     Please specify
Equipment Requested (in as much detail as possible
Please List

Purpose of facility request (Please be specific)


PLEASE NOTE THAT DEPENDING ON YOUR REQUEST AND NEEDS, THERE MAY BE FEES INVOLVED.

Please email additional information to Roxanne Ball and David Kulik as an attached file