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905.1E1 Community Use of School District Facilities & Equipment Application

COMMUNITY USE OF SCHOOL DISTRICT FACILITIES & EQUIPMENT APPLICATION FORM

The undersigned entity makes application for the use of the school district facility or equipment as designated below.  The entity will provide police protection at its own expense, if necessary, to maintain order and to properly protect the building, site, or equipment.  Police protection is required when admission is charged.

Please refer to Policy 905.1R1 to determine the proper use of school facilities and equipment.  The entity is responsible for complying with the law, board policy and the administrative regulations.

The entity must provide an Indemnity and Liability Insurance Agreement, Policy 905.1E2, prior to the use of school district buildings, sites, or equipment

Denison Community Schools

Agreement to Use Facilities

Date__________________________

Name of Organization____________________________________________________

____School Organization ____Non-Profit ____Profit-Making

Organization person in charge_____________________________________________

Address________________________________  Phone___________________

Email__________________________________

Facilities Requested_____________________________________________________

Facilities will be used for__________________________________________________

Date or dates requested__________________________________________________

Time requested_________________________________________________________

School contact person____________________________________________________

Special Instructions______________________________________________________

______________________________________________________________

Certificate of Insurance provided_________________

Fees_______________________________________________

Denison Community Schools Organization using facility

_____________________________

Signature

_____________________________

Title

_____________________________

Phone                                                                                                               

Date Board Adopted: 10/19/2009

Date Board Updated/Reviewed: 2/21/2018