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North Hunterdon High School Facilities Usage/Fundraising Form
1445 Rt. 31, Annandale, NJ 08801, 908-713-4152
APPLICATION FOR USE OF SCHOOL FACILITIES and\or FUNDRAISER/EVENT
APPLICATION MUST BE RECEIVED AT LEAST 1 MONTH PRIOR TO ACTIVITY
Please Note: All North Hunterdon and Voorhees high school activities take precedence over outside requests at any time.

Refer to the Board of Education Policies 7510, 5830 and 9210 for eligibility, rates, procedures, etc
http://policy.microscribepub.com/cgi-bin/om_isapi.dll?clientID=281136944&infobase=north_hunterdon_voorhees.nfo&softpage=PL_frame

Choose what type of event
Required
Name of Organization/Club/Activity:
Your answer
Today's Date
MM
/
DD
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YYYY
Contact Person:
Your answer
Phone Number:
Your answer
Email Address:
Your answer
Address:
Your answer
Certificate of Insurance is required for all outside groups using school facilities. If you are a non-profit organization, you must also submit your 501(c) paperwork. Your request will not be considered until you have submitted your Certificate of Insurance or a 501(c) if applicable to kellis@nhvweb.net. This must be done for EVERY request submitted.
Name of insurance company
Your answer
Policy number
Your answer
Policy Expiration Date
MM
/
DD
/
YYYY
Liability coverage (minimum $1,000,000.00 per occurrence)
Your answer
For Single Date Event Only
Staff - Please review the Teacher Handbook Calendar for date conflicts prior to submitting a date.
MM
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DD
/
YYYY
For Multiple Date Events - list dates INDIVIDUALLY
Your answer
Begin Time (SETUP start time)
Time
:
End Time (BREAKDOWN/CLEANUP)
Time
:
Event Start Time (ACTUAL start time of event)
Time
:
Event End Time
Time
:
Activity Description:
Your answer
Include a detailed description of the event. For school fundraisers, please include specific details on how funds will be raised.
Your answer
How will profits be used? – (For Staff Members only):
Your answer
# People Attending
Your answer
# of Chaperones
Your answer
REQUEST THE USE OF: (check all that apply):
Required
Any special requests regarding locations, # of classrooms, special setup or equipment needed, etc.
Your answer
Important Notes:
 Kitchen facilities available only when Cafeteria staff is responsible for work and supervision.
 KAREN ELLIS MUST BE NOTIFIED AT LEAST 48 HOURS PRIOR TO EVENT OF ANY CANCELLATIONS OR CHANGES. FAILURE TO COMPLY WOULD RESULT IN CHARGES FOR CUSTODIAL HOURS SCHEDULED
 ABSOLUTELY NO SMOKING ON SCHOOL PROPERTY
 The Supervisor of Facilities will determine and assign the necessary personnel to insure proper security and custodial coverage. Organizations are responsible for any charges incurred.
 By electronically signing this application the applicant certifies that the rules and regulations governing the use of school facilities have been received and are fully understood and accepted. The user further agrees to indemnify and save harmless the North Hunterdon – Voorhees Regional High School District Board of Education from any claim due to personal injury or property damage suffered or incurred in connection with or arising from the activities of the applicant.
Signature of Applicant
Your answer
Date:
MM
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DD
/
YYYY
Athletic/Facility Administrator Department Use Only:
Submit
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