Chelsea Recreation & Cultural Affairs

*CPS INTERNAL USE ONLY - Browne, Wright & Clark Schools Facility Request

Mar 20, 2023
submission #78
Reservation Form

Contact Person

Name/Last Name ---
Phone ---
Email Address ---
School Clark Avenue Middle School

EVENT INFORMATION

Event/Activity Name ---
Leader's Name ---
Leader's Phone Number +19783908957
Brief Description of Event ---
School Building ---
Facility ---
Total Estimated Number of Participants 100-200
Do you require special equipment or setup? ---
Please specify Only the 2 main basketball hoops should be lowered to avoid injury and confusion

Additional Questions

Will food be served? No

First Preference For Event Date

Is this event happening on one date or multiple dates? ---

First preference: Two or More Dates - Times

Dates (i.e. Every Sunday starting June 1 until September 1) ---
Times needed (i.e. 3-4:30pm) 3-4:30 PM

Second Choice Interest: Two or More Dates

If your first choice dates are not available, do you have a second choice? ---

Second Preference: Multiple Dates

Dates (i.e. Every Sunday starting June 1 until September 1) ---
Times Needed (i.e. 3-4:30pm) 3-4:30 PM
Facility (See link to park locations and descriptions above) ---
First Review by Recreation and Cultural Affairs

Decide which School should review this application:

Should Browne Principal review? No Browne Principal review necessary.
Should Wright Principal review? No, no Wright Principal review needed.
Should Clark Ave Principal review? Yes, Clark Ave Principal review needed.