COMMUNITY USE OF SCHOOL DISTRICT FACILITIES AND EQUIPMENT APPLICATION FORM
1. IF REPRESENTING A GROUP, ORGANIZATION OR COMPANY, PLEASE INDICATE GROUP NAME: ______ _____________________________________________________________________________________
2. PERSON IN CHARGE OF EVENT: _________________________________________________________
ADDRESS ______________________________________________________________________
TELEPHONE ______________________ E-Mail Address__________________________________
3. FACILITY REQUESTED FOR USE: (Circle) GYM - FITNESS CENTER –BALL FIELD – OTHER_______________
_____________________________________________________________________________________
4. PURPOSE FOR WHICH FACILITY/EQIPMENT IS TO BE USED: ______________________________________________________________________________________
______________________________________________________________________________________
5. DATE(s) THE FACILITY/ EQUIPMENT WILL BE USED: _____________________________________________________________________________________
6. APPROXIMATE HOURS THE FACILITY/EQUIPMENT WILL BE IN USE:______________________________
7. ANY SPECIAL ARRANGEMENTS NEEDED? __________________________________________________
______________________________________________________________________________________
8. ANYONE USING SCHOOL FACILITIES MUST BE RESPONSIBLE FOR THE FOLLOWING:
ATTENDANCE AT THE MEETING, FUNCTION, ETC., FOR WHICH YOU ARE HEREIN REQUESTING THE USE OF SCHOOL FACILITIES. A CERTIFICATE OF INDEMNITY AND LIABILITY INSURANCE MUST BE PROVIDED PRIOR TO FACILITY USE.
PERSONNEL, OR OTHER.
(SEE FACILITY USE REGULATION FOR AGE REQUIREMENTS FOR FACILITY USAGE)
“I AGREE TO COMPLY WITH TERMS AND CONDITIONS SET FORTH IN THIS APPLICATION AND POLICY 905.1R1 TO DETERMINE PROPER USE OF SCHOOL FACILITIES AND EQUIPMENT AND PROVIDE AN INDEMNITY AND LIABILITY INSURANCE AGREEMENT OUTLINED IN POLICY 905.1E2 PRIOR TO USE OF SCHOOL DISTRICT BUILDINGS, SITES OR EQUIPMENT.”
COMPLETED APPLICATION AND FEES MUST BE TURNED IN TO THE ADMINISTRATION OFFICE NOT LESS THAN ONE WEEK PRIOR TO REQUESTED USE DATE. SCHLESWIG SCHOOL DISRICT RESERVES THE RIGHT TO CANCEL RESERVATIONS.
SIGNATURE OF APPLICANT________________________________________________________________
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FOR OFFICE USE ONLY:
KEY DEPOSIT ($50.00) DATE REC’D________________KEY ID#_________________DATE ISSUED_________
OTHER FEES: ____________________________________________________________________________
APPROVING OFFICIAL ________________________________________ DATE ________________________
TRAINING OFFICIAL__________________________________________ DATE ________________________