Use of Facility Application

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.

Sign in to Google to save your progress. Learn more
Email *
Liability Insurance *
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 *
Name of Organization *
Event Start Date *
Event End Date *
Event Start Time *
Event End Time *
Description of Event *
Contact Person *
Contact Phone Number *
Contact Address *
Type of Organization *
Facility Space Requested (if multiple spaces are needed, please mark "Other" and specify) *
Anticipated Number of People in Attendance *
Concession/Food Options *
Admission For Attendance *
Admissions Details (if applicable)
Set Up or Tear Down Needed *
Custodial/Cleaning Needs Required *
Special Equipment to be Used/Multiple Dates of Use (District or Organization)
Clear form
Never submit passwords through Google Forms.
This form was created inside of Boone Central Public Schools. Report Abuse