Life
Education And Resource Network
Please print this form and mail OR send ALL of this information via e-mail
to the newsletter editor, Barbara McKinney, PO Box 342, Bloomington, IN 47402.
Activities Outline Guide
Date submitted:___________________________
1. What is the activity? ____________________________________________________________
2. Where is it? Address: ___________________________________________________________
Building/Room #/Parking specifics: __________________________________________________
________________________________________________________________________________
Directions: ______________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
3. Where will LEARN members gather to meet at this event? (Examples: north entrance; by the fountain; at the ticket booth) ____________________________________________________
4. When is it? Date: ________________
Time begins: _____________ Time ends: ______________
5. Is meal planning needed? Brown bag? Potluck? Eat at restaurant? ________________________
6. Who is it designed for.......is there a focus age and/or level of skills that the activity is best suited for? (For example: preschoolers? reading required? ability to sit and listen quietly? agility or physical abilities or stamina? is it a general introduction for any age? are toddlers welcome? etc.)
_______________________________________________________________________________________
_______________________________________________________________________________________
7. Will parents be expected to stay with their children? ____ YES ____ NO
8. Who is the LEARN contact person? NAME:________________________________________
Phone: _____________________ email: ____________________________
Best time to contact you: _______________________________________________
9. Is there a contact person at the activity? name: _____________________________
Phone: ___________________ email: ________________________ FAX: ________________
10. If the activity is cancelled, how will people who sign up be notified? _____________
11. Cost? ______________________________ Pay to whom? _____________________________
12. Sign up by DATE: _________________________________
13. Is there an age limit or minimum? ____ No limit _____ Limited to ages:_________________
14. Is there a minimum or maximum number of participants? ____ No limit
_____ Minimum to do activity: _________ _____ Maximum allowed: _________________
15. Does the activity need set-up or clean-up volunteers? ________________________
16. What should participants bring with them? ____________________________________
17. Special clothing needed? (outdoor, casual, white bottomed shoes, swimming, etc....)
_______________________________________________________________________________________
18. Is this activity accessible to people with strollers? ______YES _____ NO
19. Is this activity accessible to people with disabilities? ______YES _____ NO
20. Other notes: _________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
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