Application and Agreement for Use of Public School Facilities Carlstadt, New Jersey 
All applications must be submitted to the school office at least thirty (30) days prior to requested use. 
The organization or individual applying for the use of the Carlstadt Public School District's facilities shall be referred to as the "Licensee." The Carlstadt Board of Education shall be referred to as the " Licensor."

The Licensee hereby makes application for the use of :

Email *
Dates requested (Start and End dates) *
What days requested *
Required
If multiple days please list dates
Facility requested *
Required
Start Time *
Time
:
End Time *
Time
:
Additional Services needed
Misc. items
Will you need chairs? *
How many chairs will you need?
Wil you need tables? *
How many tables will you need?
Estimate number of attendees *
What is the purpose of use? *
Who is the Licensee ( Organization)? *
Address of Licensee *
Email address *
Name of Licensee *
Special Instructions
Position within organization *
Telephone Number *
Event Contact person and phone number *
Today's Date *
MM
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DD
/
YYYY
Terms of Use
The Licensee agrees to:

1. Assume all liability for and agrees to indemnify and hold the Licensor, its respective members, agents, contractors, servants, employees, volunteers, licensees or invitees, harmless from and against any and all claims, losses, damages, injuries and expenses, including reasonable attorney's fees, arising out of, resulting from, or incurred in connection with any acts or omissions of the Licensee, its members, agents, contractors, servants, employees, volunteers, licensees, or invitees related to its use of the Licensor's facilities, including but not limited to the use of any portable equipment. In the event that an action or proceeding is brought against the Licensor by reason of any such claim, the Licensee, upon notice from the Licensor, covenants to resist or defend, at Licensee's expense such action or proceeding by counsel reasonably satisfactory to the Licensor. 

2. Assume full responsibility for Bodily Injury and Property Damage incurred as a result of the acts or omissions of the Licensee, its members, agents, contractors, servants, employees, volunteers, licensees, or invitees. The Licensee must present an insurance certificate guaranteeing proper liability coverage of at least a Combined Single Limit of $1,000,000 per occurrence $2,000,000 aggregate insuring the Licensee against any liability for bodily injury and property damage. The Licensor shall be named as an additional insured on such insurance policy. The Licensee must also include an additional insured endorsement via a CG 20100704 or equivalent. A copy of the necessary insurance policy must be presented to the Licensor, upon request, prior to the Licensee's use of facilities.

3. Assume responsibility for preserving orders in said school during its use of the facilities, for all fees in connection with the Licensee's use of the facilities, including when necessary, custodial fees.

4. Observe and adhere to all of the Licensor's rules and regulations governing the use of the Licensor's facilities as set forth in the Licensor's policies and regulations. The foregoing policies and regulations are as much a part of this application and agreement as if they were attached hereto. Additional copies of said policies and regulations may be obtained at the Licensor's Business Office. any violation of these terms and conditions may result in the immediate expulsion of the Licensee from the Licensor's facilities.

5. If school is closed due to inclement weather, Licensee's event/function shall be cancelled.

6. If the Licensee is a "youth sports team organization", as that term is defined by N.J.S.A  18A:40-41.5(b), the Licensee shall provide the Licensor with a statement of compliance with the Licensor's Policy No, 2431.4 "Concussion Testing and Return to Play" for the management of concussion and other head injuries. As defined in N.J.S.A  18A:40-41.5(b) a "youth sports team organization" means one or more sports teams organized pursuant to a nonprofit or similar charter or which are member teams in league organized by or affiliated with a county or municipal recreation department.

7. If the Licensee is a "sports" organization the Licensee shall provide the Licensor with a copy of their Blanket Accident Policy, or an equivalent insurance certificate guaranteeing proper accident coverage for the participants.

8. Pursuant to N.J.S.A  18A:40-41.5, the Licensor shall not be liable for the injury or death of a person due to action or inaction of the Licensee or any of the Licensee's members, agents, contractor, servants, employees, volunteers, licensees, or invitees.

9. All charges for the use of school facilities will be paid within thirty (30) days after the Licensee's use of the facilities has concluded.

10. Any requested changes or modifications in this application and agreement for the use of facilities must be made in writing by the Licensee and approves by the Licensor at least three (3) days in advance of the date scheduled for the use of facilities.


I have read and agree to all terms of use.  *
Required
Signature *
Superintendent Signature
Business Administrator Signature
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