Facility Request Form
If your organization would like to use ISD 199 facilities, please fill out this form.

Please fill out this application at least three weeks prior to the first date of requested use. This application does not guarantee your reservation. When confirmed by our office, a building permit will be sent to you.

REQUESTOR INFORMATION
Organization name *
Your answer
Customer Type *
Required
Contact person/responsible adult (21 years or over) *
Your answer
Email Address *
Your answer
Mailing Address *
Your answer
Phone 1: *
Your answer
Phone 2:
Your answer
EVENT INFORMATION
Activity/Event Name *
Your answer
Number of people participants (total) *
If unsure, please give estimate
Your answer
Building *
Required
Location/Room(s) *
Your answer
Is this a recurring or one-time event? *
Please list specific dates/times requested below
Your answer
Do you require additional set-up/clean up time? *
If so, please list that detail below
Your answer
Pleae give a brief description of set-up
Your answer
Will you require any equipment set up? *
(Chairs, tables, audio-video equipment, gym equipment, nets, flags, etc)
If so, please list those needs below
Your answer
Will you need access to the kitchen? *
If you plan to serve food from our kitchen area, we require a food service employee to be present (to be paid for by user organization)
If requesting the Boche Memorial Stadium, will you require a stadium supervisor? *
Supervisors are required for games with spectators, or events where the scoreboard/PA system will be used
REQUIRED PAPERWORK
Required Certification of Liability Insurance *
ISD 199 requires this for those Class III, IV and V applicants. NOTE: A permit will not be issued without proper insurance coverage. Please contact elwelll@isd199.org for questions regarding this
ELECTRONIC SIGNATURE
We agree to abide by the Facility Use Policy of Independent School District 199. Users are responsible for adhering to Policy 902 in its entirety; copy available on district website or by calling Community Education, 651-306-7870. By providing an electronic signature I agree to abide by the above.
Electronic Signature of a Responsible Adult *
Your answer
Date *
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Time
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