This undersigned applicant 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 if 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.
This applicant must provide an Indemnity and Liability Insurance Agreement, Code No. 905.1E2, prior to the use of the facilities.
BUILDING: _________________________ PURPOSE: ________________________
DATE: ______________________________ HOURS: __________________________
Seating requirements on stage ____________ Seating ________ Scoreboard __________
Tables required on stage _________________ Public address system ________________
Stage curtain and attendant _______________ Matron _____________________________
Microphones __________________________ Classroom
Podium ____________ Stand ____________
Table _______ Stand in audience _________ Lunchroom
Other equipment ________________________
TOTAL FEE $__________________________
Name of organization making application: ___________________________________________
Name of person making application: ________________________________________________
Address: _______________________________ Phone: ________________________________
(Signature of Applicant) (Date)