Purdy R-II Schools Facility Use Request
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Name of Person/Organization Making Request: *
Daytime Contact Phone Number: *
Daytime Contact Email: *
I am requesting to use the following facility (Check all that Apply): *
Please provide a brief description of the event activity you will be holding at our facility: *
Please provide the date(s) and time(s) you will need the facility: *
Please list any miscellaneous district property you would like to use (chairs, podium, kitchen area, etc.):
I understand that I am liable for any and all damages incurred to the Purdy R-II School District facilities during my reservation time. *
I understand that alcohol and drugs/other illegal substances are prohibited at all times and that I and all parties in attendance will be subject to criminal prosecution should this prohibition be violated at any time. *
I understand that I/my organization is liable for injuries incurred during my reservation time, and I agree that the Purdy R-II School District will NOT be held liable. *
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