Activity Request Form 25-26

Please use this form to request an on-campus activity or event.

Name Name First Last
Email
Phone Phone - ### - ### ####
Name of Activity
Date of Request Date of Request / MM / DD YYYY
Start Date of Activity Start Date of Activity / MM / DD YYYY
End Date of Activity (if applicable) End Date of Activity (if applicable) / MM / DD YYYY
Number of Students Participating
Start Time Start Time : HH MM AM/PM
End Time End Time : HH MM AM/PM
Location

Location Classroom/Pod Media Cafeteria Covered Courts Guidance Conference Rm Music Room 1 Music Room 2 (small) Art Room 1 Art Room 2 (small) Admin Conference Rm PE Field Picnic Tables Off Campus (Field Trip)
If going on a field trip, which type of busses are needed?
Will any of the food be purchased from the cafeteria? If yes, contact Debbie Allison to order the items you need.

Will any of the food be purchased from the cafeteria? If yes, contact Debbie Allison to order the items you need. Yes No
Will field parking be needed?

Will field parking be needed? Yes No
Will parents be invited to attend?
(If yes, cones must be placed in the Fire Lane)

Will parents be invited to attend?
(If yes, cones must be placed in the Fire Lane) Yes No
Setup Needs – Furniture Moved

Setup Needs – Furniture Moved Yes No
Setup Needs – Extra Trash Cans

Setup Needs – Extra Trash Cans Yes No
Setup Needs – Notify PLACE

Setup Needs – Notify PLACE Yes No
Additional Information (Ex:Field Trip who is trained with medicine, etc.)