Note: Skip or type NA if it doesn't apply |
TYPE OF REQUEST |
Indoors / Recreation Center / Community Center / Senior Center Outdoors / Programs in the Parks Both (indoor & outdoor) |
CONTACT INFORMATION |
Applicant Name
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Phone (include area code)
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Email
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Business Name
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Website
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Social media handles
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Street address
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City, State, Zip
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PROGRAM INFORMATION |
Name of Program / Activity / Specialty proposed
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Name of Program Leader / Facilitator
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Phone Number of Program Leader / Facilitator
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Email of Program Leader / Facilitator
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Requested program start season (Check all that apply) Spring: mid-March Summer: June Fall: September Winter: November |
Estimated total duration of program (Indoor sessions are usually 8-week sessions. Scheduling is based on facility and staff availability.) 4 weeks 8 weeks 12 weeks other: |
Requested day(s) & time(s) (List in order of preference - example: Monday 6pm-7pm)
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Where will your program be held? Indoors Outdoors |
If outdoors, type preferred location(s) (List in order of preference, info located at KnoxvilleTN.gov/Parks)
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If indoors, type preferred location(s) (List in order of preference, info located at KnoxvilleTN.gov/RecPrograms. Please note that scheduling is based on facility and staff availability)
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Brief description of program
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Anticipated attendance per session
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Will this program be open to the public? Yes No |
Will there be a fee to participate in the program? Yes No |
If Yes, what is the fee to participate?
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EMAIL INFORMATION |
Please email the following, if applicable, to [email protected]
• Current Certifications (such as NCCA, ISMA, AAA-I) • Current First Aid/CPR Certification • Liability Waiver that will be used • Certificate of Insurance listing the City of Knoxville, 400 Main St, Knoxville TN 37902
as additionally insured for a minimum of $1,000,000 per occurrence and $2,000,000 aggregate and the Waiver of Subrogation endorsement |
Knoxville Parks & Recreation will be in touch following your submission.
Failure to complete this form in its entirety could delay review and approval process.
Please allow up to 2 weeks for processing once all documents are submitted. Program start date may vary based on facility / park / staff availability. |
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