CAMPUS RECREATION Facility Request Form The University of Montana Missoula, MT 59812 (rental rates available on opposite side) Club or Group requesting facility: _________________________________________________________ Contact Person: _______________________________________________________________________ Address: _____________________________________________________________________________ City, State, Zip: _______________________________________________________________________ Phone Number: _____________________________ Email Address: ______________________________ Schreiber Gym Riverbowl West Dornblaser North FRC Multi-Purpose Rm Riverbowl East (tailgate area) Dornblaser Central Tennis Courts: please indicate how many (9 available): _____ Dornblaser South For what will the facility be used? _________________________________________________________________ ****************************************************************************************** Please write out the Days, Dates, and Times you are requesting. Please be specific! ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ The undersigned, ________________________ , requests permission to enter and use the above specified premises and particular areas within the premises, located at The University of Montana, Missoula, MT, and to participate in ___________________________[indicate activities] to be held on ________[dates]. I have inspected the premises and I know the risks and dangers involved in such activities, and that unanticipated and unexpected dangers may arise during such activities. I understand that these risks can cause injury to my person and property that may be sustained in connection with the stated and associated activities, in and about the premises. I understand that my group will be responsible for the condition of the facility during the hours of occupation, and that my group will restore the said facility to pre-use condition. I also understand that my group is responsible for all damage to facility or to equipment located in said facility that occurred during our use. No food, beverages, or street shoes are allowed on the gym floors. I knowingly assume any and all risks connected with the activities associated with the use of these facilities, and agree, to the extent permissible by law, to indemnify and hold harmless The University of Montana in Missoula, its officers, agents, employees and all third party property owners where the program activities occur, from any and all costs, charges, claims demands, losses, damages, causes of action, suits and liabilities of any kind, including the expenses of litigation, court costs and attorney’s fees, for injuries to, or the death or illness of any person, or for damage to any property arising out of or in connection with my involvement in the activities except to the extent any such insured and indemnified activities result from the negligent or other tortious act(s) or omission(s) of The University of Montana in Missoula. I have read and understand the foregoing acknowledgement of risk and obligations above. ____________________________________________________ Signature of person responsible for the use of facility _____________________ Date To be filled out by Campus Rec Admin: Approved _______ Cost $________ Invoice Sent (date) ________ Pmt Rec’d (date) _________ Campus Recreation Facility Rental Rates For more information please call 243-2804. Indoor Facilities Schreiber Gym Student Groups Campus Groups Community Rates Monday - Friday --- FRC Multi-Purpose Room (all groups, per room) $5.00 / hour $20.00 / hour $10.00 / hour $20.00 / hour $20.00 / hour $20.00 / hour Rates Outdoor Facilities Dornblaser South Dornblaser Central Dornblaser North East Riverbowl Field (tailgate area) Riverbowl Field Tennis Court Rates Saturday & Sunday Less than 4 hours More than 4 hours $70.00 $70.00 $70.00 $70.00 $70.00 $100.00 $100.00 $100.00 $100.00 $100.00 Per Court / Hour Full Day Charge All Courts Private For-Profit: $6.00 $275.00 Non-Profit: $3.25 Renting courts for Tennis Instruction must be approved through Campus Recreation Management. Contact Number 243-2804. Payment is due ten (10) days prior to the reserved date. If request and approval is made within ten days, then payment is due immediately. An invoice will be sent via email or mail to the contact person, and payment can be made by check through the mail, or via check, credit card, or cash at the front desk of the Fitness & Recreation Center.