Facility Reservation Request (Note: This is a request only - a contract will be provided with confirmation of your booking Organization Name Age Group Youth (0-18 years) Adult (19+ years) Contact person: Email Phone Mailing Address Name of Activity/Event Number of participants First Choice Preferred Facilities Required for Activity/Event Field House 1 Field House 2 Gymnasium 1 Gymnasium 2 Gymnasium 3 Studio Track Meeting Room Start date Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026 End date Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026 Day(s) of the week: Monday Tuesday Wednesday Thursday Friday Saturday Sunday Start time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm End time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm For Short Term Bookings Please indicate all dates you would like to book Please indicate any dates you wish to OMIT Second Choice In case your preferred Facility/Date/Time is unavailable... Preferred Facilities Required for Activity/Event Field House 1 Field House 2 Gymnasium 1 Gymnasium 2 Gymnasium 3 Studio Track Meeting Room Start date Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026 End date Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026 Day(s) of the week: Monday Tuesday Wednesday Thursday Friday Saturday Sunday Start time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm End time Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Set-up/Equipment Requirements/Comments Please provide details Do you require a secure equipment storage space? Yes No Have you submitted your Organization's Certificate of Insurance? Yes No My Organization/I will need to purchase Insurance from the NSC Yes No I have read and filled out the form completely: * I agree to the terms and the form is complete Leave this field blank