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Facilities Use Form: Club/Project Meeting


Facility Use Form for Club and Project Meetings

To be submitted by the Project Leaders to the 4-H Office. 


** If planning a special event, please use the Event Planning Forms.

Allow a minimum of 10-14 days for processing of additional dates and times for existing insurance agreements. New agreements may take longer.

Facility Information

Some information has changed, please read!

Please contact the facility you wish to use, set dates and determine cost and if they will require a Certificate of Insurance. Some facility may also have a contract or an application to fill out. DO NOT SIGN CONTRACTS or APPLICATIONS! If either is required, the contract or application is with the University of California Extension Placer Nevada (UCCE Placer Nevada). It must be reviewed and signed by the County Director. If you sign a contract or application you are personally responsible, not the university.  Please submit the contract to the 4-H office. 

The following information is often required by the facility:

Meetings Schedule

  • If not meeting in a month, enter "0"
  • If meeting more than once in a month, enter ALL dates in that month, separated by a comma.

Keep in mind holidays and facility calendar. 

For Office Use only

Received on: _________________