New Program Proposal

 

To Potential Instructor:

 

Thank you for your interest in the Clearfield Recreation Division. It is our goal to offer a practical, fun and well-rounded slate of leisure programs to our community. We are constantly looking for new programs and activities, so we look forward to hearing more from you.

 

Please fill out the following “New Class Proposal:” completely and return it to the Recreation Division. It will enable us to evaluate your program and assess how it can best fit into our offerings.

 

Our program dates are as follows:

 

Quarter          Quarter Dates                                    Proposals Due By

Winter             December, January, February             October 1

Spring              March, April, May                              January 1

Summer           June, July, August                               April 1

Fall                  September, October, November         July 1

 

Clearfield City                                                            Community Services Department

55 South State Street                                                  (801) 525-2790

Clearfield, Utah 84015                                               (801) 525-2863 fax

                                                                                    http://www.clearfieldcity.org/

 

New Class Proposal

 

Contact Information

 

Name        

Address    

City          

State             ZIP  

Phone        Home             Cell              Work

E-Mail Address    

 

Program Information

 

Class Title:  

 

 

Goals/Objectives of the class:

Program Description:

Beginning date:     Ending date:    # of weeks:  

Day(s) of the week          

Hours from:           to:

Minimum Age           Maximum Age   

Number of participants:  Min #            Max #   

 

Clearfield City will set class fees. Do you have a recommendation of what the fee should be?

How much prep time is needed at each class meeting for setup?      

            for cleanup?   

What skill level does this program cover?     Beginner      Intermediate    Advanced

Does this program require pre-requisites?       Yes No

 

If so, please explain:

 

Participant Information

Will outside materials need to be purchased by the participant?     Yes          No

If so, what is the cost: $

Where can the items be purchased?           

Are there any materials that you will provide?     Yes     No

 

What will you provide?

Will there be a separate fee:    Yes     No               If yes, how much? $

Will materials be needed for the first class meeting?   Yes         No

Are there any special clothing requirements for the class?     Yes     No 

 

If yes, please describe:

Does the participant need a partner for the program (dance, parent/tot classes)? Yes     No 

 

If yes, please explain:

Describe to what extent parent participation will be allowed or is needed:

 

Is there any special information participants should receive about the program when registering?

Yes          No

 

If yes, please explain:

Instructor Information

 

Would you prefer to work as a:

            Part-time city employee        Independent Contractor      Volunteer

As a part-time city employee, what wage would you expect to make per hour? $

As an independent contractor, how much would you bill for your services? $

Do you have a current business license? Yes          No

Do you have liability insurance?    Yes          No

Would Clearfield City be able to be named as co-insured?     Yes          No

 

Division Support

 

Facilities needed (This refers to type and size of room, special floor, access to sink/water, etc.):

What equipment (if any) will you furnish?

Do you plan to transport any supplies and equipment to and from the facility each day or will you need storage space?

What type of publicity, outside of the city brochure, would you like to use? (Please note that all promotion must be approved and coordinated with the Recreation Division.)

Do you currently have a list of potential participants that are interested in this program?

Are there any additional comments/information about your program you would like to add?

 

Provider agrees to:

1. Meet with a Recreation Supervisor 15 minutes prior to the first class. The supervisor will provide you with a class roster and any necessary equipment from the Recreation Department.
2. Track class attendance and turn in attendance list to the Recreation Department at the end of the program.
3. Notify Clearfield City no less than 24 hours in advance if unable to appear for any class, and make arrangements with the Recreation Supervisor for a qualified substitute.
4. Provide all instructional materials necessary to conduct the class; except where special arrangements have been made with the Recreation Supervisor.
5. Abide by all Clearfield City building policies and report any damage of malfunctioning equipment to a City employee the day of the occurrence and be responsible for the damage beyond normal wear by instructor’s negligence or by failing to report damage.

 

Return completed application to:

 

Pat Bergseng

Recreation Supervisor                   Fax to:                  Press the Submit button below, and your

55 South State Street              (801) 525-2863           completed form will automatically be

Clearfield, Utah 84015                                               e-mailed to Pat Bergseng.