Facility Request for: Community RoomHigh School GymElementary GymBaseball FieldSoftball Field

Organization Name: 

Program/Activity: 

Program/Activity Date(s): 

Time(s) Needed Facility: 

Equipment Needed: 

Materials To Be Brought Into Facility: 

1. All groups must supply adequate supervision to ensure proper care and use of school facilities.

• Only the cafeteria, gymnasium, and athletic field, along with needed hallways and parking areas, are available for community use. Prior approval of the Building Principal is required.
• No furniture or equipment may be moved without prior approval from the Building Principal.
• Signs, displays, or materials may not be attached, nailed, or otherwise affixed to walls.
• All school facilities are tobacco/smoke-free.

Initial here if this is agreeable: 

2.  All groups must agree to:

• Indemnify and hold harmless the District and its agents and employees for and from any and all loss including attorneys' fees, damages, expense, and liability arising out of its use of school property.
• Pay any damages to school facilities, furniture, or equipment arising out of its use of school property whether such damage was accidental or deliberate. The cost of damages will be based on the repair or replacment cost, the choice of which is at the Board's discretion.
• Notify the Principal of any damages or hazardous conditions immediately, and to immediately discontinue the use of the premises until the condition can be corrected.
• Supply proof of insurance verifying that the group maintains adequate insurance coverage against personal injury and/or property loss:

Insurance Provider Name and Contact Number: 

Initial here if this is agreeable: 

3.  Affiliated groups may be charged for custodial expenses if:

• Activities are held while staff is not on duty.
• Additional staff or overtime pay is needed to clean the facility.
• Custodial expense: 

Initial here if this is agreeable: 

4.  The use of school facilities for school purposes has precedence over all other uses.

​Initial here if this is agreeable: 

5.  If the request involves an indoor physical fitness facility, the group must:

• Designate at least one adult who agrees to be an emergency responder. If possible, the responder should be trained in CPR and AED use.
• Require that 9-1-1 be called for medical emergencies and whenever an AED is used.
• Ensure that each designated emergency responder knows the location of any AED and completes documentation if the AED is used.

Initial here if this is agreeable: 

6.  All groups must agree to follow all District Policies.

Initial here if this is agreeable: 

I agree to abide by the conditions stated in this application and agree to adhere to all Board Policies and Administrative Procedures.

Applicant Name: 

Phone Number: 

Address: 

Email Address: 

Today's Date: