Use of Facility Application

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Terms and Conditions of Use:
1. All users must comply with the school board’s facility use and other policies, rules, and regulations. A copy of the board’s facility use policy is available upon request.
2. The facilities are closed from 10 PM to 7 AM and may not be used during those hours.
3. The user(s) named above and the individual(s) signing on behalf of the User agree to defend, indemnify, and hold harmless the school district, its employees and agents for any expense, cost, loss, damage, claim, judgment or claims bill incurred or rendered against same, including attorneys’ fees and investigation expenses (pre-suit, suit, trial, appeal, and post appeal proceedings) on account of any intentional or negligent acts or omissions of the user or its employees, agents or servants, or any intentional or negligent acts or omissions of the district or its employees, agents or servants arising out of the use of any facility under this agreement.
4. All non-governmental users may be required to provide a certificate of insurance and name the district as an additional insured, on a primary and non-contributory basis, and provide documentation evidencing general liability coverage under an occurrence basis policy, with minimum limits of $5,000,000.00 per occurrence , combined single limit covering bodily injury, property damage, personal injury, premises, operations, products, completed operations, independent contractors, and contractual liability. These coverage limits may be achieved through a combination of underlying policies and umbrella/excess policies, if preferred. There shall be no exclusions for contracted liability. All governmental users shall provide evidence of insurance or self-insurance to the limits set forth in Neb. Rev. Stat. § 13-926.
5. All users are subject to the fee schedule established by the school board, and all Applicants by signing below verify that they have authority to sign this application on behalf of the listed Organization, and all individuals and agents of organizations certify that they have financial means and authorization to pay for the required fees and deposits, if any.

Email *

Liability Insurance *

I/we have coverage of $5 million per occurrence.

I/we have other coverage

I/we have no insurance coverage

If you have other Liability Coverage, Explain

It is required that you read through the Use of Facility Policy #1200 (also located on the school website) before submitting this application for use of the Boone Central facilities *

I have read Use of Facility Policy #1200

Name of Organization *

Event Start Date *

YYYY

Event End Date *

YYYY

Event Start Time *

Time

Event End Time *

Time

Description of Event *

Contact Person *

Contact Phone Number *

Contact Address *

Type of Organization *

Student-Related Group (Non-Profit)

Community Organization (Non-Profit)

Community Organization (Commercial)

Other (Non-Profit)

Other (Commercial)

Facility Space Requested (if multiple spaces are needed, please mark "Other" and specify) *

New Gym

Performance Gym

Multi Gym

Petersburg Gym

Commons

Classroom

Other:

Anticipated Number of People in Attendance *

Concession/Food Options *

Yes

Admission For Attendance *

Yes

Admissions Details (if applicable)

Set Up or Tear Down Needed *

Set Up

Tear Down

Both

None

Custodial/Cleaning Needs Required *

Before

During

After

Before and After

Before, During, and After

None

Required

Special Equipment to be Used/Multiple Dates of Use (District or Organization)

Send me a copy of my responses.

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