APPLICATION FOR USE OF SCHOOL FACILITIES (COMMUNITY)
COMMUNITY FORM
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NAME OF ORGANIZATION: *
CONTACT NAME: *
CONTACT PHONE #: *
CONTACT EMAIL ADDRESS: *
MAILING ADDRESS:
PURPOSE FOR WHICH FACILITY IS TO BE USED: *
DATE OF USE: *
MM
/
DD
/
YYYY
PROPOSED RAIN DATE:
MM
/
DD
/
YYYY
IF EVENT RECURRING, PLEASE LIST ALL DATES BELOW:
BUILDING LOCATION: *
Required
(SETUP) REQUESTED FACILITY START TIME: *
Time
:
(BREAKDOWN) REQUESTED FACILITY END TIME: *
Time
:
ACTUAL EVENT START TIME: *
Time
:
ACTUAL EVENT END TIME: *
Time
:
AREA TO BE UTILIZED: *
Required
NUMBER OF PERSONS EXPECTED TO BE IN ATTENDANCE: *
WILL ACTIVITY BE OPENED TO THE PUBLIC: *
ADMISSION FEE: *
USE OF SCHOOL EQUIPMENT:
IF YES, HOW MANY TABLES AND/OR CHAIRS:
ELECTRICAL EQUIPMENT TO BE USED: (Please Note) All electrical equipment, if property of the school, must be operated by a school employee (i.e., lighting, sound system, projectors, air conditioning, etc.)
INSURANCE INFORMATION:
Do you (the requesting organization) have an in-force public liability policy? *
If yes, what are the limits of liability?
Your Certificate of Insurance with proper limits of liability, must be submitted at least three (3) days prior to your event.
Bodily Injury $
Property Damage $
A DEPOSIT OF $100.00 IS REQUIRED WITH THIS APPLICATION FROM ANY ORGANIZATION OUTSIDE DENNIS TOWNSHIP. THE DEPOSIT WILL BE RETURNED AFTER INSPECTION OF THE AREA OF USE PROVIDING IT IS LEFT DAMAGE FREE AND IN A CLEAN AND ORDERLY CONDITION.
Signature of Applicant/Sponsor: (Please enter your full name below) *
Submit
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