Today's Date: Organization Name( required):
On-Campus Group Off-Campus Group Contact Person (required): Contact Phone Number (required): Room Number/Street Address: Box Number/City, State: Contact Email (required): Date of Request (1st Choice): Time Requested (From - To) Date of Request (2nd Choice): Time Requested (From - To) Is your program profit or non-profit: Yes No Number of participants: Number of spectators: Approximate Number of Parking Spaces Needed Ratio of adults to youth participants: Name of person who will be on-site during event Day Phone Night Phone Cell Phone Please Note: It is the decision of the Clark Athletic Training Room Staff as to whether an on-site athletic trainer is required. The Clark Athletic Training staff has the first right to refusal to work all events at Clark ($35 an hour). If our staff is unable you will be required to hire your own athletic trainer to work your event. In the event you need to hire an athletic trainer please provide the name of your on-site medical person (Certified Trainer, EMT, etc.): : Phone Is there a fee charged to participants or teams? If yes how much? Will there be an admission charge? If Yes, How much? Will there be food, concessions, etc? Facility Requested O'Brien Softball Field Concessions Stand Announcer's Booth Restrooms Other Please specify Equipment Requested (in as much detail as possible (Please List)
Purpose of facility request (Please be specific) PLEASE NOTE THAT DEPENDING ON YOUR REQUEST AND NEEDS, THERE MAY BE FEES INVOLVED. PLEASE NOTE THAT DEPENDING ON YOUR REQUEST AND NEEDS, THERE MAY BE FEES INVOLVED. Fees may include hourly rate for facility use and hourly rate for an on-site supervisor (s) hired by Clark. You will be notified of the required fees after review of your request.
