Special Event Request Form - Recreational Sports - University of ...

Facilities RequestedUniversity of Wisconsin-MadisonDivision of Recreational SportsSpecial Event Request Form*Minimum 2 weeks notice for University Organizations*Minimum one month notice for Non-University OrganizationsOrganization Requesting Space:Type of Organization:(Check all that Apply)University DepartmentStudent Organization (registered)Athletic Department Community Club SportLocation of Event:Submitted By:On-Campus EventOff-Campus EventTelephone:Email:Fax:Local Address:Facility Requested:Area Requested:# of Fields/Courts Requested:Event Type and Description:Number of Participants:Participant Type:(Check all that Apply)StudentsFacultyStaffPLEASE LIST THE DATES AND TIMES THAT WE COULD TRY TO ACCOMODATE YOUR EVENT IN ORDER OF PREFERENCE.IF MORE THAN ONE DATE IS NEEDED, PLEASE NOTE THAT BELOW AND LIST ALL EXACT DATES NEEDED.Please check which applies: One Day Event Multiple Days NeededDates: MM/DD/YY(List all dates Needed)Time(s): AM/PM Requested(Include setup and take down time)Date:Start Time:End Time:Date:Start Time:End Time:Date:Start Time:End Time:Date:Start Time:End Time:NOTE: As conditions warrant, this office will exercise the authority to cancel an event due to weather or othersituations affecting outdoor or indoor space use.

Equipment RequestedPLEASE BE SPECIFIC WITH NUMBER NEEDEDScorer TablesBadminton NetsBadminton RacquetsPinniesGarbage CansVolleyball NetsWallyball NetsDodgeballsSoftball BatsScoreboard ControlsMen's BasketballsWomen's BasketballsOutdoor BasketballsFootballsRubber BasesStop WatchesSand VolleyballsEquipment BagsSoccer BallsPortable ScoreboardsTablesChairsExtension CordsClipboardsConesVolleyballsWallyballsFlag BeltsTug of War RopeSoftballsDate and Time Equipment will be picked up(All equipment needs to be picked up and returned to the Nat)Date:Time:Signature of Responsible Party:Date:ORReturn Printed Forms To:UW Recreational Sports, Room 275 SERF, 715 W. Dayton Street, Madison, WI 53715Phone: 890-0158Fax: 262-7152FOR OFFICE USE ONLYAPPROVED DECLINEDTOWEL/EQUIPMENT ROOM STAFFEquipment Prepared By:Equipment Received By:Director of Recreational Programs and FacilitiesDate Prepared:Date ReturnedDateAll equipment returned in satisfactory condition? Yes NoIf no, provide specific details:

Special Event DetailsPLEASE CHECK THE APPROPRIATE BOXWill there be any food sold or distributed at this event?YESNOIf so pleaseexplain.Will there be any vending of any merchandise?YESNOIf so pleaseexplain.Do you require any staff for clean up after the event?YESNODo you need the equipment requested setup in the area(s) requested?YESNOWill there be any non-UW students, faculty or staff participating in the event?YESNOWill the facility supervisor need to check in on your event?YESNOIf so, what will you needtheir services for. Pleaseexplain in detail.Do you need your field(s) lined by our Division?YESNOIf so, what typesof fields, howmany lined, forwhat sport, etc.Please explain.Do you need keys to the Far West Bathroom/Shelter? YES NO