For Officials Contact Im Coordinator 593-4771

Office Use Upon Submission: Facility Request Form for Date: ______Campus Departments and Private Groups FOR OFFICIALS CONTACT IM COORDINATOR 593-4771 Received By: ______

Form Complete: ______

Date Submitted ***FORM MUST BE FILLED OUT COMPLETELY AND SUBMITTED 2 WEEKS IN ADVANCE. ***

CONTACT INFORMATION

Person Responsible for Request

Address City State Zip

Contact Number Email Address

Department, Private Group, or Sponsoring Organization:

I have read and understand the Student Recreation Center Reservation Guidelines.

Requestor’s Signature ______Department Account # (for fees/costs)

(For Student Organizations Only):

Advisor Name______Phone ______E-mail______Does a university department co-sponsor the event No Yes

Requestor’s Signature______Advisor’s Signature______

EVENT INFORMATION

Event Name Approximate Number of People ***IF PARTICIPANTS ARE NOT MEMBERS OF THE SRC, A COMPLETE GUEST LIST MUST BE TURNED IN ADVANCE. ALL GUEST(S) MUST BRING A PICTURE ID AND MUST BE LISTED TO BE ALLOWED INTO THE FACILITY. *** Please provide a description and purpose of the event (BE SPECIFIC).

Indicate event dates and times below: First Choice Second Choice

Space Requested Space Requested

Day(s) & Date(s) Day(s) & Date(s)

Time of Event Time of Event (beginning/ending) (beginning/ending)

Set-up Time Set-up Time

Prior to event, requestor will (check one)

Submit liability waivers for each participant Purchase insurance from TAMUK Provide proof of liability insurance

ADDITIONAL INFORMATION

Will food be served at the event? (If yes, attach menu or food list.) No Yes

Will fees or donations be collected? $ Per team/ participants No Yes

Will signage be used for the event? (All signage must be approved by Campus Rec.) No Yes

Will minors 16 years of age or under attend the event? No Yes Is this reservation for a camp? (If yes, please also see our Student Recreation Camp Rules) No Yes

Do you need any sports equipment? (If yes, list equipment needed.) No Yes

FACILITY OPTIONS

There is no facility fee for Texas A&M University Kingsville Departments requesting facilities exclusively for use by the campus community. For all other requests open to the outside community the facility hourly rates are as follows: Indoor Facilities Cost for Open Event Hours Total

Lobby – Per Floor $8.00/ hour (Max $80.00)

Indoor Running Track $20.00/ hour (Max $200.00)

Gym – Per Quadrant $10.00/ hour (Max $100.00)

Gym – One Court $20.00/ hour (Max $200.00)

If requesting gym court area, curtains must be: Up Down (curtain(s)? Outdoor Facilities Cost for Open Event Hours Total

Outdoor Basketball Court $15.00/ hour (Max $150.00)

Intramural Field – One Field $15.00/ hour (Max $150.00)

Intramural Field – Two Fields $30.00/ hour (Max $300.00)

EQUIPMENT OPTIONS Equipment Cost Quantity Total

Rectangle Tables (6’) $5.00 each

Chairs $1.50 each

Tip n Row Bleachers (Gym area only) $25.00 per section

Gym Floor Covering $60.00

Field Paint $25.00 per field

STAFFING OPTIONS (Required staff may apply) Position Quantity Price per Hour Hours Total CONTACT IM Official (s) COORDINATOR X-4771 Physical Plant Support Prices vary depending on services rendered. When form has been completed please turn in to Student Recreation Center room 203 and schedule an appointment

with Charles Espinosa, 361-593-3057 to discuss your event layout and needs.

OFFICE USE ONLY – Form updated 10/17/2013 Do Dates interfere with Campus Recreation and Fitness programs?

IM Coordinator Initials: ______Fitness and Wellness Coordinator/Lecturer Initials: ______Cheer Coach Initials ______Director Initials: ______

Office Notes

Approved as requested Approved with noted change Request declined

Approval Signature: ______Date: ______

REQUEST CONFIRMATION: ______Date:______

Event Director: ______Date: ______

Amount Due: $______Paid: $______Receipt #: ______