Lyme School District - Facilities Use Request
Form used to submit a facilities usage request per Board Policy KF-R.  Please understand that the Lyme School reserves the right to deny any request for facilities usage.  
 (Revised September  2022)
Sign in to Google to save your progress. Learn more
Email *
First Name: *
Last Name: *
Organization (if applicable)
Address: *
Phone Number: *
Does you or your organization have a certificate of liability insurance on file with the school?  If no, please provide a copy of your certificate of insurance to aperry@lymeschool.org *
Date of Event: *
MM
/
DD
/
YYYY
Start Time: *
Time
:
End Time: *
Time
:
Please list additional dates with times if there are more dates beyond one:
Approximate Number of People: *
Approximate Number of Vehicles: *
Which space are you looking to use: *
Please describe your event and the specifics about the location you would like to use: *
Acknowledgement
By submitting this form, you (or on behalf of an organization) are making a request to use a Lyme School District facility.  

If approved, you are acknowledging that you will take responsibility for this event and that you will ensure that no doors are propped open, the facility is locked, and the space used is cleaned up afterwards.  You agree to provide adequate adult supervision at all times during the use of the facility; and you will assume responsible for all fees, charges, and damage claims resulting from such use of the facilities.  Loss of building key/fob will be subject to re-keying/replacement fees. 

Food and drink is not allowed in the following areas: Art Room, Music Room, Design Lab, and Gym.

Please abide by all posted signs throughout the school building.  We take pride in our space and we hope you do too.  

Thank you for your request, someone will be back in touch with you shortly.   
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Lyme School.

Does this form look suspicious? Report

Google Forms