Camden Hills Regional High School
Request for Facility Use

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                                                                                         Today’s Date_____________________

Organization: _______________________________________________________________

Event: ______________________________________________________________________

Rate Category:  ___________ Fee Paying
                          ___________ Non-Fee Paying

Contact Name: _____________________________________________________________

         Address: _____________________________________________________________

            Phone: ________________________   Email: ______________________________

Date of Event: ______________________________________________________________

Time of Event: ______________________________________________________________

   Set-up Time: ______________________     End Time: ______________________

Rooms Requested:  ____________ Strom                       ___________Classrooms
                               ____________ Black Box                ___________ Café
                               ____________ Band Room              ___________ Chorus Room
                               ____________ Gym                         ___________ Mini Gym
                               ____________ Café with Kitchen    ___________ Dressing Rooms
                               ____________ Practice Fields          ___________ Varsity Fields
                               ____________ Parking Lots             ___________ Field or Lot with                                                  ____________ Track                        ___________  Concession

            Equipment:  ____________ Piano Baby Grand   ___________ Piano Upright
    
NOTES:

Return request to Amy Clevette at CHRHS or FAX to 207-236-7813

    
     Notify: __________Keith           ____________Rick          ____________Mark

     Calendared: _________________               Deposit Rec’d: ______________
     Contract Sent: _______________                Event Billed: ________________
     Contract Rec’d: ______________               Invoice Paid: ________________
     Insurance Rec’d: _____________