University of Wisconsin-Madison Division of Recreational Sports by que48750

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									                          University of Wisconsin-Madison
                          Division of Recreational Sports
                          Special Event Request Form
Facilities Requested
*Minimum 2 weeks notice for University Organizations
*Minimum one month notice for Non-University Organizations

Organization Requesting Space:
Type of Organization:           University Department          Student Organization (registered)
(Check all that Apply)
                                Athletic Department            Community                Club Sport

Location of Event:              On-Campus Event                Off-Campus Event

Submitted By:                                                   Telephone:

Email:                                                          Fax:

Local Address:

Facility Requested:

Area Requested:

# of Fields/Courts Requested:




Event Type and Description:




                                                Participant Type:
Number of Participants:                                                      Students         Faculty             Staff
                                                (Check all that Apply)

PLEASE 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 Needed
Dates: MM/DD/YY                                     Time(s): AM/PM Requested
(List all dates Needed)                               (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 other
situations affecting outdoor or indoor space use.
Equipment Requested
PLEASE BE SPECIFIC WITH NUMBER NEEDED

Scorer Tables                            Men's Basketballs                                 Tables

Badminton Nets                           Women's Basketballs                               Chairs

Badminton Racquets                       Outdoor Basketballs                               Extension Cords

Pinnies                                  Footballs                                         Clipboards

Garbage Cans                             Rubber Bases                                      Cones

Volleyball Nets                          Stop Watches                                      Volleyballs

Wallyball Nets                           Sand Volleyballs                                  Wallyballs

Dodgeballs                               Equipment Bags                                    Flag Belts

Softball Bats                            Soccer Balls                                      Tug of War Rope

Scoreboard Controls                      Portable Scoreboards                              Softballs

Date 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:


   Submit by Email          OR      Print Form

Return Printed Forms To:
UW Recreational Sports, Room 275 SERF, 715 W. Dayton Street, Madison, WI 53715
Phone: 890-0158
Fax: 262-7152




FOR OFFICE USE ONLY
APPROVED          DECLINED
                                        Director of Recreational Programs and Facilities                 Date

TOWEL/EQUIPMENT ROOM STAFF

Equipment Prepared By:                                         Date Prepared:

Equipment Received By:                                         Date Returned
All equipment returned in satisfactory condition?       Yes           No


If no, provide specific details:
Special Event Details
PLEASE CHECK THE APPROPRIATE BOX


Will there be any food sold or distributed at this event?      YES         NO


If so please
explain.


Will there be any vending of any merchandise?                  YES         NO


If so please
explain.


Do you require any staff for clean up after the event?         YES         NO


Do you need the equipment requested setup in the area(s) requested?              YES    NO

Will there be any non-UW students, faculty or staff participating in the event?        YES   NO

Will the facility supervisor need to check in on your event?         YES        NO


If so, what will you need
their services for. Please
explain in detail.

								
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