Southern Cayuga CSD Building Use Form
Requests for building use during the summer, weekends and holidays when no staff is on duty have different requirements. Please call the District office for more information

SCCS will charge the following rates for the use of its facilities. School-Related Organizations No use of facilities fees charged for school sponsored activities. Non School-Related Organizations Non-profit organizations • Regular shifts – no use of facilities fees charged • Outside regular shifts o $100/up to four hours for auditorium o $50/day each for gymnasium o $25/day each for kitchen, fitness center/weight room, classrooms For-profit organizations when activity benefits students and/or community • Regular shifts o $50/up to four hours for auditorium o $25/day each for gymnasium o $10/day each for kitchen, fitness center/weight room, classrooms o Or pre-approved arrangements to donate annually to an approved SCCS Booster organization • Outside regular shifts o $100/up to four hours for auditorium o $50/day each for gymnasium o $25/day each for kitchen, fitness center/weight room, classrooms For-profit organizations when activity is purely for profit making • Fair market value NOTE: In a contingent or austerity budget, use of facilities rates for all non school-related organizations will be established, using a cost per square foot. All School and Building Procedures and Policies must be followed, including, but not limited to: Building Evacuation upon fire alarms or administrative direction, No parking in Fire Lanes or Reserved spaces, etc.

Requestor Name *
Please enter First and Last name
Your answer
Organization Name
Please enter the name of your Group, Club, or Organization
Your answer
Event Name
Please enter the name of your event
Your answer
Date Requested
Please enter the date(s) for your event
MM
/
DD
/
YYYY
Block of Time Requested
Please enter the overall block of time needed
Your answer
Beginning Time *
Please enter the beginning time of your event
Time
:
End Time *
Please enter the and end time of your event
Time
:
Describe your Event *
Please describe the nature of your event
Your answer
Facilities Requested *
Please enter the building and/or buildings requested
Required
Equipment Needed *
Please enter any additional equipment needed
Required
Room Requested *
Room Number Requested
Your answer
Estimated Number of Participants *
Your answer
Supervisor Name *
Please enter the name of the individual and/or individuals supervising the event
Your answer
Will there be an admission cost associated with the event? *
If you answered "Yes" to the previous question please include the cost of admission
Your answer
Please indicate what the proceeds will be used for
Your answer
Contact Name *
Your answer
Contact Title within the organization
Your answer
Address of the organization or contact
Your answer
Contact Phone Number *
Your answer
Contact E-Mail Address
Your answer
Insurance Information *
Required
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