Seneca School District Facility Use Request
What is the name of your organization? *
Your answer
What type of organization? *
Name of Contact Person *
Your answer
Phone Number *
Your answer
Address
Your answer
Email Address *
Your answer
Purpose of use *
Your answer
What date are you requesting the building for? *
MM
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DD
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YYYY
Time
:
What areas, equipment and personnel are you requesting? *
Enter specific classroom # and specifics in "other"
Required
Any further information we need to know?
Your answer
The above named person has responsibility for supervision of the group and proper maintenance of the facilities and equipment. At least one adult must be present during the entire time the facility is used. To support the request to rent/utilize property of the Seneca School District set forth above, I (applicant or authorized agent of applicant) hereby agree as follows: To abide by the rules and regulations of the school district governing the use of school facilities, and to see that such rules and regulations are complied with and obeyed by others; to assume responsibility for and to make restitution for any damage to the building or equipment during the period of rental/use which in the judgment of the school district constitutes damage or destruction beyond normal wear and tear and intended usage; and to indemnify and forever hold harmless the school district and its officers, agents, and employees, from any and all claims of any kind, nature or description arising out of the use of any of the school facilities pursuant to this application or any modification thereof. I REPRESENT AND UNDERSTAND THAT I AND/OR THE ENTITY FOR WHICH I AM THE AUTHORIZED AGENT AM, AND WILL BE, FINANCIALLY RESPONSIBLE AND LIABLE FOR ANY PROPERTY DAMAGE OR PERSONAL INJURY ARISING OUT OF RENTAL/USAGE OF SAID FACILITIES. *
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