Application for Permission to Use School Facilities
Application for the use of facilities must be made on this “Facilities Usage” form at least 14 days ahead of time. Use of facilities by other than school groups will be restricted to such times that it will not conflict with school use of facilities.

Please Note: You MUST have an updated Web Browser, such as Google Chrome, to complete this form.

Requested Building *
Room/Area *
Please be specific...
Your answer
Dates/Times
Event Starting Date *
List the day of your event, or the starting date if it is a recurring event.
MM
/
DD
/
YYYY
Event Ending Date:
Leave this field blank if your event only occurs on one day.
MM
/
DD
/
YYYY
List Specific Dates:
Use this field to list specific dates of events that would not have weekly occurrence, for example, this field would be used to specify a monthly event.
Your answer
Days that Event Take(s) Place
Use this field only if your event is recurring.
Explanation/Details
Your answer
Time Entering Building (including setup) *
Example: 8:00 AM
Your answer
Activity/Event Time Start *
Example: 9:00 AM
Your answer
Activity/Event Time End *
Example: 11:00 AM
Your answer
Time Exiting Building (including tear-down/cleanup) *
Example: 11:30 PM
Your answer
Does your event warrant setting up the night before? *
Event Details
Name of Organization *
Your answer
Type of Activity *
Your answer
Anticipated Attendance *
Your answer
Supervisor *
Your answer
Supervisor Phone *
(xxx-xxx-xxxx)
Your answer
Will You Charge Admission? *
Admission Charge Amount (If Applicable)
Your answer
Purpose of Proceeds (If Applicable)
Your answer
Indicate any additional needs, as only those noted can be provided.
Your answer
Building Use Categories
School Organization: Organizations directly affiliated with the Capac Community Schools may use facilities free of charge during a time when a custodian is normally on duty. If a custodian is not on duty, a charge may be made based on cost of personnel required. (Decisions made by Superintendent). These groups will have reasonable priority over all others.

Non-Profit: Any organized non-profit group or organization, membership of at least seven individuals, within the school district whose purpose are civic, cultural, fraternal, or recreational in character, may use school facilities at a charge based on the costs of personnel required (based on current contracts).

Private/Profit Making Group: Any private and/or profit making group whose interests are limited exclusively to a membership, consisting of at least seven members, of said group, or all other groups or organizations not mentioned above, i.e., out of district groups may use school facilities at a charge based on cost of personnel (based upon current contracts) and usage fee:

- Classrooms $10/hr
- Gymnasiums $35/hr
- Multi-Pirpose Rooms $25/hr
- School Kitchens $10/hr

Please Select Your Category *
Contact Information
Name of Person Filing Application *
Your answer
Email Address *
Your answer
Address *
Your answer
City *
Your answer
State *
Zip Code *
Your answer
Home Phone Number *
(xxx-xxx-xxxx)
Your answer
Alternate Phone Number
(xxx-xxx-xxxx)
Your answer
Comments
Your answer
Terms and Conditions
ALL School property has been designated as a NO SMOKING complex by the Board of Education.

SCHOOL SPONSORED ACTIVITIES HAVE FIRST PRIORITY. THE USE OF SCHOOL FACILITY BY GROUPS MAY BE CANCELLED AS SCHOOL SPONSORED ACTIVITIES ARISE

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Submitting this form does not guarantee approval. Request is pending until you receive an approval confirmation via email or by USPS. If you have any questions, contact the district at (810) 395-4321.

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I understand that Capac Community Schools assumes no responsibility or liability for injuries/illnesses to any participant. I further understand that I hold Capac Community Schools, its officers, agents, employees, and volunteers harmless from any and all liability or claims which may arise out of participation in the following event(s). I also understand that I may be held responsible for any damage to the school building and or its equipment.

By checking the box below and clicking submit I understand and agree to all terms and conditions *
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