Ignacio Schools Facility Use Form
Submitted by: *
Email address: *
Mailing Address
Contact Phone Number
Name of Organization
Description of Activity
Is there a fee to attend your activity? (How much?)
Regulations for the administration of Policy E-7.0 Facility Use *
There may be a Fee for facility $______________ Waived YES______ NO__________ Donation $ ___________ Audio/visual Equipment needed: (for out of district users there will be a required per hour fee for certain equipment) Outside entities must have a district custodian on duty during the event. ($25.00 per hour) A Food Service employee must be on duty whenever the kitchen facilities are being used. ($25.00 per hour) Final billing will be mailed by Finance Department **** User is required to clean facility after use. Failure to clean facility will result in facility cleaning fee based on hourly rate of $25.00 per hour Proof of Insurance Must be Submitted: An administrator will be notified of your request and you will be notified of his/her decision as soon as possible. Indemnity and Hold Harmless Waiver I and my organization agree (hereinafter “user”) agrees that Ignacio School District-11JT (hereinafter “School District”) shall be free from all liability for claims and damages and/or suits, or by reason of any injury or injuries to any person or persons, or property of any kind whatsoever, whether the person or property of the User, its agents or employees, or third persons, from any causes while in or upon the Ignacio School District Facilities (hereinafter referred to as “Facility”) or any part thereof while the Facility is being used for the purposes agreed upon by the School District and User or occasioned by any occupancy or use of the Facility or activity
Required
Proof of insurance (Administration): *
For certain activities Insurance may be required,
Required
Start Date
MM
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DD
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YYYY
Start Time
Time
:
Finish Date
MM
/
DD
/
YYYY
Finish Time
Time
:
Facility Location
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