Facility Request Form

Gold Crown Foundation

Field House Facility Reservation Request
The Gold Crown Field House is a youth sports facility. We do not accomodate any adult reservations.
Organization Name:*
Group Contact Person:*

First NameLast Name
Name of Insurance Policy:
Please upload Certificate of Insurance:

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Address (Must match credit card billing address):*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Jefferson County Resident

Yes
Nonprofit Organization

Yes
Please Upload Valid Tax Exepmt IRS Documents*

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Cell Phone Number:*

Area CodePhone Number
Other Phone Number:

Area CodePhone Number
Email:*
Activity:

BasketballVolleyballOther
Activity Type:

PracticeGameTournamentCampOther
Special Requests (request a specific court, etc.):
Additional Rental Items (fees may apply):

BasketballsVolleyballsMicrophoneFolding TablesFolding ChairsScoreboard (for practice)Other
Single Session Reservation
Date:

MonthDayYear
Date
Start Time:

:HourMinutesAM/PM Option
End Time:

:HourMinutesAM/PM Option
# of Courts:
Recurring Reservation
Event Begin Date:

MonthDayYear
Date
Event End Date:

MonthDayYear
Date
Start Time:

:HourMinutesAM/PM Option
End Time:

:HourMinutesAM/PM Option
# of Courts:
Day(s) of Week:

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Exclude these Dates in Range:
Event Information
Anticipated # of Teams:
Anticipated # of Participants:
Anticipated # of Spectators:
Jeffco Residents (Court rates are for one court)

Practice/Camp ($50/hour)Game ($60/hour)Special Event ($60/hour)Admissions/Gate ($500/day)Classroom ($50/hour)Vendor ($200/day)Equipment ($20/day)
Standard Rates (Court rates are for one court)

Practice/Camp ($55/hour)Game ($70/hour)Special Event ($70/hour)Admissions/Gate ($500/day)Classroom ($50/hour)Vendor ($200/day)Equipment ($20/day)
Non Profit Rates (Court rates are for one court)

Practice/Camp ($40/hour)Game ($50/hour)Special Event ($50/hour)Admissions/Gate ($250/day)Classroom ($40/hour)Vendor ($100/day)Equipment ($10/day)
Terms & Conditions
Signature*

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Gold Crown Foundation