Today's Date:
*Sponsoring Organization (represents who is legally responsible for this proposed event):
      
*Contact Person (legally responsible for event):
     
*Mailing Address:

*Day Phone:   Cell Phone:   Fax:
*Email:

Please provide as much information as possible. If you have questions, call 419.372.8686.

*Brief description of the activity or event you are planning:

*Total number of activity/event dates you are requesting: (up to 5 reservation dates per form)

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If you are requesting a RANGE of dates, with no specific date requirement, please complete this section. If you are requesting SPECIFIC dates, proceed to the next section and complete the ACTIVITY/EVENT REQUEST details.

The earliest date your group could use the facility:
The latest date your group could use the facility:

Please click on the days of the week you are interested in:

      Mon Tue Wed Thu Fri Sat Sun

The earliest time of day your group could begin activity (please specify am/pm):
The latest time your group could finish up activity (please specify am/pm):
The length of time for each reservation request: hours

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If requesting SPECIFIC date(s), please complete this section. If requesting more than five (5) dates, contact Lona Leck to provide additional date requests.

Activity/Event Request #1
Day/Date:

Time(s) desired, including when:
*Set up begins (please specify am/pm):
*Activity/event begins (please specify am/PM):
*Activity/event ends (please specify am/PM):
*Take down ends (please specify am/PM):

 

Activity/Event Request #2 (only complete if requesting more than one date)
Day/Date:

Time(s) desired, including when:
*Set up begins (please specify am/PM):
*Activity/event begins (please specify am/PM):
*Activity/event ends (please specify am/PM):
*Take down ends (please specify am/PM):

 

Activity/Event Request #3 (only complete if requesting more than two dates)
Day/Date:

Time(s) desired, including when:
*Set up begins (please specify am/PM):
*Activity/event begins (please specify am/PM):
*Activity/event ends (please specify am/PM):
*Take down ends (please specify am/PM):

 

Activity/Event Request #4 (only complete if requesting more than three dates)
Day/Date:

Time(s) desired, including when:
*Set up begins (please specify am/PM):
*Activity/event begins (please specify am/PM):
*Activity/event ends (please specify am/PM):
*Take down ends (please specify am/PM):

 

Activity/Event Request #5 (only complete if requesting more than four dates)
Day/Date:

Time(s) desired, including when:
*Set up begins (please specify am/PM):
*Activity/event begins (please specify am/PM):
*Activity/event ends (please specify am/PM):
*Take down ends (please specify am/PM):

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*Anticipated number of BGSU student participants (do not include spectators):
*Anticipated number of non-BGSU participants (do not include spectators):
List age range of participants (if a youth group):
*Anticipated number of coaches/instructors/chaperones:
*Anticipated number of spectators:

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*Check each facility area(s) requested (see Area and Equipment Description and Rental
Rates  for area descriptions and costs). Additionally, take a  Tour of the Perry Field House, view a  Diagram of the PFH Turf and Track Rooms , and be sure to review the PFH Usage Policy :
Turf Room (check all that apply: Entire Room 1/2 Room Batting Cages)
Track Room (check all that apply: Number of courts requested (1-4) 200 meter track)
 Meeting Room (Describe seating needs):
     
Conference Room
Foyer/Lobby
Sports Care Center

*Check each facility equipment requested (and identify quantity and type desired):
Soccer Goals (qty large (up to 2); small (up to 4)
Scoreboards (qty fee for non-BGSU users)
Public Address system (fee for non-BGSU users)
Tables (fee for non-BGSU users) qty 8' rectangle (up to 6); qty small rectangle (up to 15); qty 5' round (up to 10)
Chairs (fee for non-BGSU users) qty 90 with desktops; qty 50 without desktops
Bleachers (seating for how many? fee for non–BGSU users -- 12 bleachers seat approximately 550 people)
Other Equipment (please specify):

*Is the group providing athletic trainer or medical personnel? yes no

Please review the Perry Field House Food/Drink Vendor & Merchandise Policies :

*Is food being provided, served or sold? Please explain:

*Are drinks being provided, served or sold? Please explain:

Any additional information? Please provide special set up needs, additional date explanations or any other pertinent information.

After you submit your request, do not forget to print out the "Form Submitted" page, which should appear after you submit your request. This will serve as a confirmation that your form was submitted. If you have any questions, contact Lona Leck or call 419.372.7235.

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Office use only
Date received
Response given
Contract completed