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905.1E1 COMMUNITY USE OF SCHOOL DISTRICT FACILITIES & EQUIPMENT APPLICATION FORM

Code No.  905.1E1

 

COMMUNITY USE OF SCHOOL DISTRICT FACILITIES & EQUIPMENT APPLICATION FORM

 

 

The undersigned entity makes application for the use of the school district facility or equipment as designated below.  The entity will provide police protection at its own expense, if necessary, to maintain order and to properly protect the building, site, or equipment.  Police protection is required when admission is charged.

 

Please refer to Policy 905.1 to determine the proper use of school facilities and equipment.  The entity is responsible for complying with the law, board policy and the administrative regulations.

 

The entity must provide an Indemnity and Liability Insurance Agreement, Code No.  905.1E2, prior to the use of school district buildings, sites, or equipment

 

 

Building/Site/Equipment

 

Date

 

 

 

 

 

Purpose

 

Hours

 

               

 

Seating ______________________________

 

Custodian _________Yes, ______No                 Cook _______Yes, ________No           

 

 

 

Total Fee $                                                              

 

Name of entity making application:

 

 

 

 

 

Name of person making application:

 

 

 

 

 

Address:

 

Phone #:

 

           

 

 

 

 

 

(Signature of Applicant)

 

(Date)

 

 

 

_________________________________________

Signature of Supervisor for the Entity (Individual with full responsibility for use of the facilities)

 

 

_________________________________________

Date