GPS Activity Usage Request Form

Request edit access

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Use this form to request the usage of an area of the school or grounds for your company events.

Name of Group/Entity *

Contact Name *

Give contact person Name

Contact Number

Contact email

Name of Event *

Date of Event *

YYYY

Start Time of Event *

Time

End Time *

Time

Non-profit *

Yes

Indicate which facilities requesting *

SH-Senior High, JH-Junior High, CE- Century Elementary

SH Gym

JH Gym

CE Gym

SH Kitchen

CE Kitchen

SH Commons

JH Commons

CE Commons

Classroom (If checked, use "other" to mark what classroom number)

Parking Lot

Track

Fields

Auditorium ($250 Flat fee + expenses)

Other:

Required

Special Requests

If your even has 50 or more people attending, Custodial Labor will be required. (CL) Custodial Labor must be selected above - (TL) Tech Labor must be selected below

Bleachers (CL)

Chairs (CL)

Tables (CL)

Garbages (CL)

Sound System (TL)

Projector (TL)

Computer (TL)

Stage Lighting (TL)

Other:

Indicate which assistance requesting *

Custodial Labor (Approx $25/hour - minimum 1 hour)

Tech Labor (Approx $25/hour - minimum 1 hour)

Utilities Charge ($25)

Delivery In-Town ($50)

Delivery Out-of-Town ($50 + Mileage @ State Rate)

None

Other:

Required

Indemnification Agreement *

You or your company agree to defend, indemnify and hold harmless the Grafton Public School from any claim, demand, suit, loss, cost of expense or any damage which may be asserted, claimed or recovered against or from the Grafton Public School by reason of any damage to property, personal or bodily injury, or death arises out of or is incident to or in any way connected with the performance of this contract, and regardless of which claim, demand, damage, loss, cost of expense, is caused in whole or part by the negligence of the Grafton Public School, or by third parties, or by the agents, servants, employees or factor of any of them. If you agree, select Yes.

Yes

Sign *

Date *

YYYY

Submit

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