Bucknell Social Event Registration Form
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1SERF
BUCKNELL SOCIAL EVENT REGISTRATION FORM
SERF
Name of Organization (Do Not Abbreviate):
Event Date:
Contact Person (print):
Signature:
Phone #:
Campus Box #:
Position: Social Chair
Risk Mgr Other:
University Adviser:
Signature:
Please circle all items that apply -
Location:
House
Campus Venue: _____________ Off-Campus: ______________ Event Theme: _________________
Type/Description of Event: Party (type): ______________
Formal
Philanthropy
Other: ____________________
Source of Entertainment:
Band
DJ
None
Other: ___________________ Outdoor Event: ___________________
Additional Needs:
Dining Services: _______________________________
Phys. Plant: _______________________________
Time Event Begins: _____________(AM/PM) Time Event Ends: _____________(AM/PM)
Alcohol?
No
Yes
If yes, please complete section below
Est. Attendance: ________ Admission Fee (if any): ________ Open to Campus?: Yes No Open to Campus?: Yes
No
Floor Access Required
List Doors Being Requested: ______________________________________
(During Event): Y / N
Floor Access for Clean-up
List Doors Being Requested: ______________ Time/Date: ______________
(Limit to 2 hrs.): Y / N
Security Monitors from the Organization Responsible for Supervising the Event:
Name (print)
Signature
Phone Number
1)
2)
3)
NOTE: THIS SECTION MUST BE COMPLETED IF ALCOHOLIC BEVERAGES ARE PERMITTED AT THE EVENT
Type of Service:
BYOB
Other: _______________
Kind and Amount: ____________________________________
Alternative beverages: ______________________________
Food/snacks
: _________________________________
(quantity)
Destination of the segregated area located: _______________ Private Security (name): _______________________________
When having a party or other social event where alcohol will be consumed, a completed Registered Social Event Risk
Management Duty Schedule and Invitation List must be attached to this form.
On behalf of the student organization, I have read and agree to abide by the University’s alcohol policy as contained in the Student Handbook and on
the reverse side of this form, and all other risk management policies, regulations, and/or procedures relevant to my organization. I understand that
the completion and acceptance of this form only indicates registration of the social event, it does not signify University sponsorship or approval of
the event.
Date:
Signature:
Chapter President
Date Received:
Received By:
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