Form Center

Eagle Parks and Recreation Camp & Class Submission

2. Thank you for your interest in offering a new recreational opportunity to our community!
   Please complete this Program Proposal Form and submit it to Recreation staff for evaluation and review. This form does not constitute a contract or qualify for application for employment. The City of Eagle does not discriminate against race, gender, gender identity, ability, age, birth place, income, cultural background, religion or ideology.

   Please complete this Program Proposal Form and submit it to Recreation staff for evaluation and review. This form does not constitute a contract or qualify for application for employment. The City of Eagle does not discriminate against race, gender, gender identity, ability, age, birth place, income, cultural background, religion or ideology.

4. First Name*

5. Last Name*

6. Pronouns:

   She/ He/ They

8. Address

10. City

11. State

12. Zip Code

14. Email Address:*

15. Phone Number:*

17. Bio:*

    Please provide two or three sentences about yourself.

19. Certification:

    Please provide any certifications that you hold pertaining to this class submission.

21. Name of Program/Event*

23. Description of Program/Event:*

25. Goals of Program/Event:*

27. Instructor in Charge:

    List if different than above.

28. Is there a co-presenter?

    If yes, please list.

30. Frequency of Program/Event:*

31. Proposed Start Date:

32. Proposed End Date:

34. Start Time:

35. End Time:

36. Are your times and dates firm?*

38. Available Days of the Week:

    1. Monday
    2. Tuesday
    3. Wednesday
    4. Thursday
    5. Friday
    6. Saturday

39. Available Times of the Week:

    1. Morning (8-12 PM)
    2. Afternoon (1-5 PM)
    3. Evening (6-10 PM)

41. Location:

    Leave blank if you don't have a specific location in mind.

42. Proposed Fee:

    $________ per person (you receive 70% of rate.)

44. Is the program intended for a specific age group?

45. If yes, what is the minimum age?

46. If yes, what is the maximum age?

48. Please list below any needed supplies for participants:

    Example: knitting needles, notebook...etc.

50. Please list below any special site or set-up requirements needed for the program:

    Example: projector, tv, extension cords... etc.

52. Will you need any assistance during or before class due to accessibility?

    Example: Interpreter, wheelchair access, etc. So we may provide you with needed assistance if necessary.

Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field