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Wellness Center Reservation / Rental Request Form
Please complete the entire form to request a reservation. A email reply will be provided within 48 hours. Most rentals require a fee for use. The total fee and any additional approvals will be included in the email response.

General Information
*indicates required fields
Subject
Department / Sponsoring Organization:*
Event Description:*
   
Name of Individual Making Request:*
Email Address:*
Campus Phone Number:*
   
Name of Contact Person who will be on-site at event:
Cell Phone Number: 
     check if Contact person is the same as Individual Making Request
 

Date and Time Request
Requested Date of Event:    Day of Week:   
Estimated Attendance    
Start Time of Event:    End Time of Event:   
Time Required for Set-Up:    hours Time Required for Clean-Up:    hours
 

Clean-up will be completed by:    User Group       MCG Environmental Services      Wellness Center

*a fee will be assessed for ENVSVCS or Wellness Center staff clean-up.
 

Space / Location Request
     Gymnasium - as intended (basketball, etc)      Group Exercise Room - as intended
     Gymnasium - special event (TGIF, reception, etc)      Outdoor Recreation Area
     Gymnasium (Half) - as intended      Other Area - please indicate below
     Entire Facility          

All spaces with the exception of the Outdoor Recreation Area require a fee for rental. The Gymnasium (Special Event) requires the installation of a floor cover.

Requests for DA-2001, DA-2021, or the Second Floor Lobby of the Student Center, should contact Student Affairs at (706) 721-3356. For information regarding the Dining Area, please contact Auxiliary Services at (706) 721-4101.

Please note if your requested activity will involve the following:
(In each case listed, pre-approval is required before the event will be scheduled. Please click on the item for the list of requirements and approvals.)
 
     Service of Food  -   (requirements)
     Service of Alcohol  -  (requirements)
     Fundraising Event or Charging of Entry Fees  -  (requirements)
     Start or End Outside Regular Business Hours
 

Special Services Request
If this is a special event, please identify the following services required. If services are required, the renting group is responsible to contact and arrange for service 10 days prior to the event. Contact information will be provided in the reply email. A fee may be required.
 
     Special Arrangement / Set-Up of Tables and Chairs
     Special Arrangement / Electrical or Internet Connection (110 or 220 volt; wireless; etc)
     Special Arrangement / MCG Classroom Services (sound system, video display, etc)
     Other:
     Other:
 

Additional Comments

 
 

Reservation Agreement
I have reviewed and understand the rules and regulations pertaining to the use of the facilities and agree to abide by them. I agree to pay any fees assigned for the rental and agree that failure to pay will result in the cancellation of the event. I also understand that I am required to arrange for any special considerations/services as designated.

 

Copyright 2007
Medical College of Georgia
All rights reserved.

MCG Wellness Center
Please email comments, suggestions or questions to:
wellness@mcg.edu.
June 25, 2007