Parks and Recreation

561 Main Street South
Southbury, CT 06488
Maps and Directions

P:(203) 262-0633
Monday - Thursday:
8:00am - 4:30pm
Fri: 8:00am - 1:00pm

Program Proposal

Prospective Instructor,

Thank you for your interest in providing programs with the Town of Southbury! The Southbury Parks and Recreation Department sponsors a diverse range of events, activities, and programs for the youth and young at heart of the Town of Southbury. These offerings are designed to meet the physical, social, cultural, and educational needs of the community for those of all ages.

The Southbury Parks & Recreation Department will review any program for inclusion in our offerings. All program proposals must be complete and meet all applicable requirements. Program proposal must be submitted at least 120 days prior to the anticipated start of the program to be considered. This ensures ample time for the creation of the program, logistics, scheduling, promotion and registration. This is not a guarantee of the time required to review a program as the process may be longer. We want to be sure your program is a success!

The following information is required in order for your proposal to be considered as an addition to our program offerings:

Completed form below
Necessary documents (can be uploaded into the form or emailed to spanaccio@southbury-ct.gov)
- Proof of Insurance (if operating at facility outside our purview)
- Any necessary class related certifications

Due to limited facility space, not all program proposals will be considered. Also, proposed programs that are too similar to current offerings in the Southbury area may not be considered.

Southbury Parks & Recreation instructors are expected to manage their programs. This includes:

Purchasing and preparing supplies needed
Additional marketing/advertising if desired
Set-up/take down of equipment
Cleaning up after each class, including spot cleaning floors, tables, and chairs where necessary, closing and stacking tables, stacking chairs, and tidying bathrooms
Ensure quality program content and curriculum
Communicate to roster for additional class needs or cancelations due to weather

When possible, we provide facilities and equipment. We handle program registrations, payments, refunds, customer calls, and program inquiries within reason. At the end of each session, the agreed upon rate per participant will then be processed and paid to the instructor.

Once the Program Proposal is approved, you will be required to submit a completed IRS W-9 Tax Form prior to being contracted and paid for your services. You may download the form here: https://www.irs.gov/pub/irs-pdf/fw9.pdf.

We look forward to hearing from you.

Southbury Parks & Recreation
561 Main Street South, Southbury
spanaccio@southbury-ct.gov
Phone: (203) 262-0633

Program Proposal Form

Instructor / Organization Information

Instructor or Contact Person

OrganizationIf applicable.

Email Address

Contact Phone Number

Additional Contact Phone NumberIf applicable.

Address Full address, as included on your W-9.

Emergency ContactName, Relation and Phone Number.

Please include name and contact information for each additional instructor who would be conducting classes:

Additional InstructorsName, Address, Email and Phone Number for each.

Program Details

Program Name

Program DescriptionBriefly describe what your program participants will be doing.

List of ALL Materials NeededList of all materials, supplies, and equipment participants will need to take part in your program (include handouts/reference materials, pens, folders, and all supplies).

List of Supplies You Will ProvideOf that main list above, list supplies you will provide for the participants.

List of Supplies to PurchaseOf that main list above, list supplies participants must purchase to bring with them to class.

Equipment RequestedEquipment you will request from Southbury Parks & Recreation to furnish for your program (i.e. tables, chairs, sink, etc. This equipment is not guaranteed to be available.)

Type of Facility Required

Different SpaceIf different space is needed, please describe what kind.

Number of Classes for the Program

Suggested Start Time for the ClassMornings, afternoons, evenings, or specific time.

Duration of Each Class

Number of Sessions of the ProgramHow many sessions of this program would you offer each year?

Please note that due to the limited space and time available at our facilities, we may not be able to accommodate your proposed class times, dates or locations. If this is the case, we may contact you to suggest alternate times/locations.

Requested Participant Fee(s)

All program registration fees are paid directly to the Town of Southbury. Fees are then paid to the instructors per session, based on the fee that is agreed upon between SP&R and the Instructor. Please create this fee aiming for a registration cost for the total length of your program session that splits as follows: SP&R keeps 20% and you receive 80%, less any non-resident fees. Fees may not be based on a flat rate per program session basis.

Registrant Fee$

Instructor Payment

Number of students to run class, based on above instructor take-home amounts and program capacity.

Minimum Enrollment

Maximum Enrollment

Participant Ages

Description for PostingProgram description for Southbury Parks & Recreation Online Posting: (“Sell” your program to potential participants in 45 words or less).

Proof of InsuranceRequired if operating at facility outside our purview.

CertificationAny necessary class related certifications.

Please submit a picture (or two) of your program, if available, so we can use it to advertise your program. Please only submit photos that you personally took or have permission from the copyright holder to use.

Picture of the Program

Additional Picture of the Program

Additional Comments

Instructor SignatureA typed name will substitute for a handwritten signature.

Date