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Facilities Use Request - FUR - 4-H PLACER - COUNTYWIDE EVENTS

 
Facilities Use Request - FUR - 4-H PLACER - COUNTYWIDE EVENTS

Facilities Use Request Form for CLUBS and COUNTYWIDE EVENTS

Before the event can be posted on the website or included in the newsletter the following information MUST be given to the 4-H office.

If Planning a club meeting or a project meeting, please use the
Placer County 4-H Facilities Use Agreement Request: MEETINGS Club project

 

PLEASE NOTE: Incomplete request will create delay in processing your request in a timely manner. use the checklist below to insure you have all the needed information.

CHECKLIST:

  1. Name/contact info of person requesting the facility - (4-H club leader/project leader)
  2. Facility/Location available for dates needed - (contact facility, verify, and confirm dates)
  3. Additional forms required by facility - (contact facility to ask and obtain forms, if any)
  4. Facility physical address – (where meetings will take place)
  5. Facility contact name, email & phone - (not the same as person requesting)
  6. Dates and times needed for meetings – (Include set-up and clean-up times)

 

Any questions, contact us at placer4h@ucanr.edu or call us at 530-889-7386

Please allow a MINIMUM of 10-14 days for the processing of any additional dates and times for existing insurance agreements.

**NEW AGREEMENTS may take longer.**

Any request sent with missing information will be sent back and add delay in completion.

FACILITY INFORMATION

Insurance Coverage from UC is required for most locations.
Homeowners locations will ALWAYS require a Certificate of insurance from UC. 
Upon submission of your Facility Request the following required paperwork will be sent to you by the 4-H office:

Attachment D and Proof of homeowner Insurance coverage declaration page.

FILL OUT this portion if HOMEOWNER LOCATION is being used

FILL OUT this portion if LOCATION IS OTHER LOCATIONS (not Private Property)

** Some facilities require additional paperwork to secure a reservation, such as an application or rental agreement. 

For liability reasons, DO NOT FILL OUT or SIGN any contracts or applications.

Forward any documents to the 4-H CES or upload at the bottom of this request form.

   

EVENT INFORMATION

   
   
   

EVENT PREPARATION

   
   

Please Note: A FUNDRAISER FORM (Form 8.7) MUST be submitted for Approval by the 4-H Office prior to advertise for the Event. 

   

The 4-H Office Staff is available to provide support with formatting, creating, and posting of any registration or information related to the event. 

NOTE: All Information needed to be posted online for public view, need to be reviewed and approved by the 4-H office prior of posting or publishing. 

If you have a contract, agreement  and/or application to submit, please use the upload option below. Thank you. 




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