Your Personal Information
* Your Full Name:
Required
* E-mail:
Required Valid email required
* Group Requesting: Required
* Phone: Required
* Mail Code:
Required
Responsible Party(if different from your name):
Responsible Party Phone:
Event Information
* Event Title
Required
* Date of Event
Required
* Venue Requested:
Gym
Other:
* Set-Up Time:
Required *Please allow extra time for special setups
* Actual Start Time:
Required
* End Time:
Required
Setup
* Number of Chairs:
Required
* Number of Tables:
Required
A/V Equipment Needed
Exercise Equipment
Gym Policy/Procedures
*
Check box required. I understand and accept that I am responsible for ensuring that all Valencia Community College policies, rules and regulations are adhered to by my group. I further understand that I am responsible for the following:
Gym must be left clean and in order, how you found it
There must be faculty/staff supervision at all times
No Food or Drink
No Gum
No Profanity
Treat equipment with respect (examples: do not smash ping pong balls, hang from basketball hoop rims, put balls through ceiling tiles)
YOU MUST CONTACT SECURITY FOR OPENING, CLOSING, AND SECURING OF EQUIPMENT. THIS MEANS THAT IF YOUR EVENT STARTS BEFORE 8AM OR ENDS AFTER 5PM (NORMAL BUSINESS HOURS), YOU MUST CALL SECURITY TO UNLOCK AND LOCK THE FACILITIES AND EQUIPMENT.
Please use this space to tell us a little more information about your event, including table/chair setups, special needs, etc.
You will receive an email upon confirmation.
For Additional Questions- Contact Debi Jakubcin, Ext. 2281, M - F 9AM - 4PM.
Please Note: If you do not receive a "Thank You" message,not sent!
Faculty & Staff 
