Event Information

Campus: Location Airport Ash Flat Ash Flat Technical Center Melbourne Mountain View

Event Title:

Date of Event:

Estimated Time Required (In Hours): (please include time for set-up, practice, takedown, etc.)

Time Event Begins:

1 2 3 4 5 6 7 8 9 10 11 12 : 00 15 30 45 AM PM

Time Event Ends:

1 2 3 4 5 6 7 8 9 10 11 12 : 00 15 30 45 AM PM

Type of Space Requested: Amphitheater Auditorium Cafeteria Classroom Lecture Hall Lobby Outdoor

Estimated Attendance:

Organization Information:

Name:

Contact Person:

Phone Number:

Email Address:

Any Additional Notes:

My organization and/or I have been informed of the facilities usage policy for Ozarka College and agree to abide by the conditions provided within. I agree to the facility usage rate for the space I wish to use and understand additional fees may be assessed for excessive cleaning and/or key replacement if needed. I accept full responsibility for any damage to Ozarka facilities caused as a result of or by those attending this event. As event sponsor, I assume liability for accidents occurring on the Ozarka campus during the course of this event. In addition, I understand that Ozarka will not be held liable for accidents or personal items which are lost or stolen while the facilities are being used.



Completion of this form should not be considered confirmation of any request. Confirmation will be provided after the college administration approves this request. This form should be completed at least 72 hours in advance.