NSU Intramurals Equipment Rental Form

Please don't fill out this input box.

Organization Name*

First Name*

Last Name*

Address*

City*

State* Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code*

Telephone*

NSU Email Address*

Date(s) of Event*

Title of Event*

Start Time*Including setup

End Time*including break down

Number of Attendees Expected*

Purpose of Event*

Proposed NSU Location* Please Select Bill Gessner Sports Complex Rec Plex Indoor Basketball Courts Rec Plex Outdoor Basketball/Tennis Courts Rec Plex Multipurpose Room Rec Plex Racquetball Court Other

Is this event open to the public?* Please Select Yes No

Sports Equipment Requested *

Football

Flag Belts

Soccer Ball

Basketball

Volleyball

Softball Bat

Softball Bases

Cones

Kickball

Pinnies

Other

Check all that apply

Payment*

I understand that an invoice will be sent to my NSU email address, containing a $25 total charge for equipment rented. If any equipment is returned damaged, or is lost or stolen, I assume the full price of replacement.

Is Rec Well staff requested?*

Yes

No

If Yes, how many staff members requested? Please Select 1 2 3 4 5 6 7 8 9 10

Start time for Rec Well Staffincluding setup

End time for Rec Well staffincluding break down

Invoice for Staff*

I understand that the invoice will include the cost to pay Rec Well staff. The rate for each Rec Well staff member is $15/hour.

Rec Staff not needed

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