905.1E1 - Community Use of School District Facilities and 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 security at its own expense, if necessary, to maintain order and to properly protect the facility or equipment.  Security is required when admission is charged.

Please refer to Policy 905.1 to determine the proper use of school district 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 facilities or equipment.

 

Building/Site/Equipment		Date
Purpose		Hours

 

Auditorium			Gymnasium
Seating requirements on stage			Seating		Scoreboard
Tables required on stage			Public address system
Stage curtain and attendant			Matron
Spotlights
Microphones			Classroom
Podium Stand			ICN
Table		Stand in audience			Computer lab
Other equipment			Other

 

                                                                                                                                                                                                                                                              Swimming Pool

 

Total Fee $                                                               

 

Name of entity making application:
Name of person making application:
Address:		Phone #:

 

 

(Signature of Applicant)		(Date)