Facility Usage Form

Facility Usage Form
User Information
Name*

First NameLast Name
Organisation*
Date*

DayMonthYear
Date
Address*

Address Line 1

Address Line 2

ParishCountry

Post Code
Home Phone*
Please enter a valid phone number.
Cell Phone*
Please enter a valid phone number.
Email*
example@example.com
User' Status*

SA ParentSA StaffCommunity/Charity
Facility Usage Information
Facility space(s) being requested: (select all that apply)*

GymnasiumCommon RoomSports FieldClassroomPlayground AreaDP Common RoomLibraryKitchen
Amenities you will need access to: (select all that apply)*

Electrical powerBathroomsPorch area for shelterPicnic tablesAccess 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*

MonthDayYear
Date
Start & End Time*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
For specific locations and dates please indicate below.*
Special Requirements*

TablesChairsAudiovisual EquipmentNoneOther
Please verify that you are human
Should be Empty:

User Information