Name of Event: ______________________ Date of Event: __________________

Scheduled by: ________________________ Date of Scheduled: ______________

Approved by: ________________________ Date Approved: ________________

Copies to:  ____ info@immac-concept.org _____ Maintenance Chief ______ Rectory Office

Group Name: ____________________________________________________________

Nature of Function (briefly): ________________________________________________

Name of Person in Charge: ___________________ Daytime Phone # _______________

Evening Phone # _______________

Event Time:

From: _________ To: _________ Number of People expected to attend ______

Set up Time:

From: _________ To: _________ Food or Beverage ______YES _____ NO

1. The basic #1 rule is that the gym is to be always left in the condition that it was found!

2. The requesting organization is expected to provide any help needed to set-up the gym.

Due to staffing reductions, our maintenance team is limited in the assistance they are

able to provide. For planning purposes, please indicate below what equipment you plan on using:

Individuals who will do set-up: __________________ ___________________

3. If small children will be present during preparation or tear-down, who will supervise/care for them?

4. Tear-down responsibilities/Checklist: COMPLETE

5. Special Notations: ___________________________________________________

Misc. Equipment needed: ____________________________________________