Facility Usage Form
User Information
Name
*
First Name
Last Name
Organisation
*
Date
*
-
Day
-
Month
Year
Date
Address
*
Address Line 1
Address Line 2
Parish
Country
Post Code
Home Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
User' Status
*
SA Parent
SA Staff
Community/Charity
Facility Usage Information
Facility space(s) being requested: (select all that apply)
*
Gymnasium
Sports Field
Classroom
Playground Area
DP Common Room
Library
Kitchen
Amenities you will need access to: (select all that apply)
*
Electrical power
Bathrooms
Porch area for shelter
Picnic tables
Access to field for bouncy castle set up
Purpose of using space(s): (a general explanation of the type of event(s) being held in each space)
*
Number of expected participants: (include spectators, instructors, etc.)
*
Date & time facility space(s) are to be utilised:
Start time should be the time the group needs access to the facility space(s). The end time should be the time that all participants will have left the facility space.
Date
*
-
Month
-
Day
Year
Date
Start & End Time
*
Hour Minutes
AM
PM
AM/PM Option
Until
until
Hour Minutes
AM
PM
AM/PM Option
For specific locations and dates please indicate below.
*
Special Requirements
*
Tables
Chairs
Audiovisual Equipment
None
Other
Please verify that you are human
Submit
Should be Empty: