Facility Use: Category 2 Not For Profit Group/For Profit Group With WCUSD#5 Participants
Email address *
Requests for the 2019-2020 School Year will not be accepted until July 1, 2019. Any request submitted prior to July 1, will be denied and/or deleted and you will have to resubmit the request after July 1. Thank you for your understanding and cooperation.
Event Date(s)- If recurring please list dates. Example: T & Th from Jan. 22- May 8 *
Renters must provide for their own liability insurance protection and name Waterloo Community Unit School District No. 5 as an additional insured. The minimum amount of insurance is $1,000,000. Please upload below, bring a copy to the Central Office, or email to marla@wcusd5.net. Your request will not be approved until your certificate of insurance has been received by the district.
Insurance Certificate *
Upload Insurance Certificate
I understand that Waterloo Community Unit School District No. 5 will accept no responsibility of injury to members of said group while the members of said group use the facilities of the school. Therefore, I understand that my signature releases Waterloo Community Unit School District No. 5 from all liability associated with said group using the District's facilities. Said group agrees to indemnify, defend and hold said District, members of the Board of Education and all employees of said District harmless to all claims resulting from injury occasioned by or arising out of the said group’s use of the District's facilities. I further understand the conditions required in Section 830 of the Waterloo Community Unit School District's Board of Education policy as outlined on this form. "The representative who signed this form: 1) represents that he is authorized to act on this request for the organization named above; 2) understands that granting of this request does not constitute recognition of such organization as a school-connected group nor use of the building space or other facility by the organization is not covered by school insurance; and 3) agrees that such organization will not represent itself or any of its activities as school-connected. A regular school custodian and other school personnel, as may be required, shall be present and in authority over the school properties while properties are being used for other than school purposes. Non-school affiliated organizations or individuals using school facilities shall be liable for any and all claims, demands and causes of action which may at any time be made or instituted against the District arising out of or in connection with their occupancy of any part of the facilities. The organization or individual shall be fully responsible for and shall indemnify the District against damage to school property occasioned by or arising out of the organization's or individual's use of the property. All permits for rental will be issued for specific areas and specific hours. It shall be the responsibility of the organization or individual to see that unauthorized portions of District facilities are not used and that the premises are vacated as scheduled. The District shall not be liable for personal property lost or stolen. Use of tobacco products, alcoholic beverages, and controlled substances shall not be permitted on school premises. Profane language cannot be tolerated. It is the responsibility of the organization or individual to enforce these regulations as well as reasonable and appropriate standards for conduct in every respect. A room used by the organization or individual shall not exceed the legal maximum seating capacity for that room. Organizations using school facilities shall provide at all times adequate adult supervision to insure proper care of and use of school property. Type your initials below to reflect your understanding of the above.
Liability- Initial For Agreement *
The WCUSD5 reserves the right to change its Rental Agreement rates without prior notifications to parties who reserve facilities beyond the expiration date of this agreement. The Board or its designee may waive all or portions of the rental charge on school conditions as it may from time to time establish for any organization whose use of the District's facilities involves athletic activities involving primarily students who are currently enrolled in the School District. School Board Polity No. 8:20. Additional charges may apply if additional labor is required for the event. The facilities department reserves the right to add additional custodians for clean-up following an event to insure the facility is returned to its pre-event condition in a timely manner. *School scheduled events take priority and may conflict with your request. If a conflict with your request arises, the District will work with you to make other arrangements. Type your initials below to reflect your understanding of the above.
Rental Agreement Rates- Initial For Agreement *
Organization *
Contact's First & Last Name *
Contact's Phone Number *
Organization Billing Address *
Event Title *
Event Start Time *
Event Set-Up Time *
Event End Time- (Elementary locked by 7:45 and JH/HS by 10:00) *
Anticipated # of Adults *
Anticipated # of Children *
School- Please fill out a new request for each school *
Room(s) and/or Field(s) and Hourly Cost(s)- There is an additional cost for event set up and clean up (1/2 hour minimum set up and 1 hour minimum clean up) added to the rental cost. *
Equipment Needed and Hourly Cost(s) *
Setup Requirements- If you need any equipment please provide details/quantities
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