COMMUNITY
USE OF SCHOOL FACILITIES
1. ORGANIZATION:_______________________________________________________________________________
2. INDIVIDUAL RESPONSIBLE(Print):______________________________________________________________
3. ADDRESS:____________________________________________________________________________________
4. TELEPHONE:__________________________________________________________________________________
5. BUILDING & SPACE REQUESTED:
________________________________________________________________
6. EQUIPMENT REQUESTED:
_______________________________________________________________________
7. PURPOSE OF THE ACTIVITY:
___________________________________________________________________
8. HOW MANY PARTICIPANTS DO YOU ANTICIPATE?____________________________________________________
9. DOES YOUR GROUP CHARGE A FEE TO PARTICIPANTS?
NO______YES______AMOUNT_______________________
10.
LIST DATES REQUESTED:_______________________________________________________________________
11.
ENTRY & EXIT TIMES: ________________________________________________________________________
Certificates
of insurance need to be submitted from all non-school
organizations that use school facilities. (Board Policy 9.05)
Organizations
using the school facilities for profit or for their own personal use shall be
charged a fee of $75 per day per building or per ground of which $25 per day is
nonrefundable. The remaining amount to be returned shall be determined by the
amount of work to be done by school employees to get the facilities back to
their original state.
Any
organization using the facility (building or grounds) and is in need of
custodial or kitchen help shall pay the rate of time and one half of the salary
of that employee unless a school employee will donate their services to the
organization. If the school employee does not donate their services, the school
district will pay the employee and bill the organization.
(Board
Policy 8.03)
I
have received and read the
_______________________________________________________
______________________
Signature Date
Please
return to the Principal of the building being requested.
APPROVED
______ MODIFIED APPROVAL ______ NOT APPROVED ______
KEY(S)
ISSUED #___________________________ KEY(S) RETURNED____________________________
DISTRICT
FEE CHARGED ___________________
_______________________________________________________
_____________________
Principal’s Signature Date