Conference Services Single Day Event ApplicationEvent Coordinator's Contact InformationFirst NameLast NameEmail AddressPhone NumberExtensionCell Phone NumberOrganization's InformationName of OrganizationDescription of organizationOrganization website (paste url)Type of OrganizationType of OrganizationAlumni Group - Non-RockhurstCivic GroupGrassroots Community GroupNonprofit/Community OrganizationNeighborhood AssociationYouth-Serving OrganizationBusinessOtherIs your organization a recognized nonprofit organization by the State of Missouri?Is your organization a recognized nonprofit organization by the State of Missouri?YesNoPlease list your EINDoes your organization have proof of liability insurance? Please upload a copy of your organization’s liability insurance below or email a copy of the liability insurance to breyanna.primous@rockhurst.edu. You are welcome to contact us with any questions regarding this. Does your organization have proof of liability insurance? Please upload a copy of your organization’s liability insurance below or email a copy of the liability insurance to breyanna.primous@rockhurst.edu. You are welcome to contact us with any questions regarding this. YesNoPlease upload your proof of liability insurance:Mailing AddressCountryStreetCityRegionPostal CodeEvent NameEvent NameDate of EventFirst Date PreferenceSecond Date PreferenceThird Date PreferenceWhat is the estimated time frame of your event? (ex: 10:00am - 4:30pm)Is you event a single day or multiple days?Is you event a single day or multiple days?Single DayMultiple daysIf your event is multiple days, please indicate how many days you will be on campus.Event ParticipantsPlease provide as accurate information as possible. This information will help us determine if our campus and facilities are appropriately equipped to host your event.Approximate Number of ParticipantsAge Group of ParticipantsAge Group of ParticipantsYouthTeenagerCollegeAdultHow many minors in your group?How many participants are ages 4 to 5?How many participants are ages 6 to 8?How many participants are ages 9 to 14?How many participants are ages 15 to 17?Organizations with children on campus will need to follow the University's Policy Statement and Guidelines for Minors. Information on this policy is contained in the Brooks Center (Community Space Usage) Policies at the end of this form. Organizations needing further details, copies of the policy, and paperwork required for minors on campus should contact Alicia Douglas, Director of Community Relations and Outreach, at 816-501-4306 or by email: breyanna.primous@rockhurst.edu. If the organization would like to request an exemption from the policy, please contact Breyanna Primous.Adult chaperones must supervise children under the age of 18 at all times: One staff member for every six participants ages 4 to 5 One staff member for every eight participants ages 6 to 8 One staff member for every ten participants ages 9 to 14 One staff member for every twelve participants ages 15 to 17 How many adult supervisors will be in attendance?Event DetailsFacilities Needed for your EventFacilities Needed for your EventAlvin Brooks CenterAthletic FacilitiesAuditoriumClassroomsConference RoomsExterior SpaceMeal SpacePlease note that capacity in Alvin Brooks Center cannot exceed 60 people.Please give a more detailed description of the facilities you will need.Number of Parking Spaces NeededWill parking be for school busses?Will parking be for school busses?YesNoWill you be using Rockhurst Catering Services?Will you be using Rockhurst Catering Services?YesNoAll meals served on campus must go through Chartwells, Rockhurst's dining services provider.Will there be media at your event?Will there be media at your event?YesNoIs your event open to the public or a closed event by invitation only?Is your event open to the public or a closed event by invitation only?Open to publicInvitation onlyAdditional AmenitiesPlease check which additional amenities you will be needing during your event. Note: these amenities may come at an additional cost and will be discussed with you during further even-planning conversation with Conference Services.Additional AmenitiesAdditional AmenitiesAfter Hours AssistanceEarly/Late AccessLinensSpecial Room Set-UpTechnology AssistanceWi-Fi AccessHow did you hear about hosting your event with Rockhurst University Conference Services?How did you hear about hosting your event with Rockhurst University Conference Services?Nonprofit ConnectUnique VenuesReferralWeb SearchI have hosted an event here beforeOtherIf you selected "Other", please explain:Acknowledgment - I acknowledge that this form neither guarantees reservation of my event spaces(s) at Rockhurst, nor services as a binding contract. But I acknowledge that if I complete the contracting process, I will be responsible for making a 50%, nonrefundable deposit. Please initial below.Submit