Directions:   This form is to be completed by the community adult requesting use of a district building and/or equipment a minimum of three (3) days prior to the date the building and/or equipment is to be used.  Please complete the form in full.  If you have questions, the superintendent or secretary will assist you.

 

1. Date of Request – today’s date.                                                                                                    
2. Date use of Building/Equipment is desired.               ______________________________
3. Estimated time of use on the above date.                       ______________________________
4. Building name and area within the building.                    ______________________________                                                                                               
5. School district equipment desired.                                     ______________________________
6. Purpose for desiring to use the building and/or equipment – please describe in detail.   
           __________________________________________________________________________________
           __________________________________________________________________________________
7. Name of person completing this form.    __________________________________________________    
8. Name of group you represent.   _________________________________________________________

 

PERSONAL LIABILITY

I acknowledge that I am to be considered personally liable for the use of the building and/or equipment and for the activity to occur within the building as described above.  Should any damage to the building and/or equipment occur as a result of the activity described above I agree to assume personal liability for such damage and agree to pay the district for any necessary repairs or replacement of equipment, etc. as deemed appropriate by the district.

 

 ________________________________       _______________         ___________________________
Signature                                                                                         Date                               Phone Number

 

 

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The following section is to be completed by the Superintendent or Designee

_____ Request approved                  ______ Request denied                    ______ Fee Charged

_____ A copy of the building use rules & regulations has been given to the individual.

_____ A key has been given to the individual requesting use of the building.

_____ Use fee has been paid in full _______________________________________
                                                                                               Date use fee paid

 

 

 

________________________________________________________                 __________________
Superintendent’s signature or Designee                                                                                                 Date

 

 

 

Approved 01-15-90                         
Reviewed 08-18-03; 01-19-09; 08-10-16
Revised 09-17-03

 

1.      Alcoholic beverages will not be brought to or consumed in the school district facilities or grounds.

2.      Smoking is prohibited in school district facilities.

3.      A custodian or employee must be present while the school district facility or equipment is being used by an entity.

4.      After a school district facility or site has been used by an entity, cleaning, including restoring the facility or site to the condition it was in prior to its use, will be done by employees assisted by a committee from the entity.  The fee charged to the entity for the use of the facility or site will include these costs.  However, if excessive costs are involved in cleaning or otherwise restoring the facility or site to the condition it was in prior to its use, the board reserves the right to charge the entity for these excessive costs. 

5.      After school district equipment has been used by an entity, the equipment must be returned to the school district in the condition it was in prior to its use.  The fee charged to the entity for the use of the equipment will include these costs.  However, if excessive costs are involved in restoring the equipment to the condition it was in prior to its use, the board reserves the right to charge the entity for these excessive costs. 

6.      Entities are required to stay within the area of the school district facility or site and use only the school district equipment authorized by the school district for use by the entity.  Other school district facilities, sites, or areas in the school district building or equipment are off limits to the entity.

7.      A cancellation after the facility or equipment is made ready for the entity will be charged at the full rate.  Cancellations made prior to that time will be charged a minimum cancellation fee or the costs incurred to the school district in anticipation of the entity's use, whichever is greater.

 

	Wolcott Center	$15.00
	Wolcott Center with Kitchen	$20.00
	Classroom	$ 5.00
RATE C - Use by local individual or group for social or recreational purpose when no admission charge or collection is taken.
Rates for Use of Buildings and Sites
	Gym	$25.00
	Wolcott Center	$10.00
	Wolcott Center with Kitchen	$15.00
	Classroom	$ 5.00
RATE D – Use by local educational, patriotic, or service organizatons, where no admission charge or collection is taken.  (Examples:  school sponsored activities, adult educational programs, gym-walkers, scouts and 4-H meetings, fund raisers for local educational purposes, etc., or the activity has the general welfare of the community as the focus and has the approval of the Superintendent.
Rates for Use of Buildings and Sites
	Gym	$0
	Wolcott Center	$0
	Wolcott Center with Kitchen	$0
	Classroom	$0

Add to above:
	Custodial charges – if needed	Time & 1/2/hour

APPROVAL PROCEDURES

1. The Superintendent and administration will review he request to use the building to judge its appropriateness and to set rental fees, as set for in the board policy.
2. The Superintendent may also deny a request for the use of any school facility.  Reasons for denying the request can include such things as, (1) facility being used for school purposes, (2) lack of payment for use, (3) use may be detrimental to facility, (4) damage from previous use, (5) lack of proper supervision, (6) or any other reasonable cause.
3. The Superintendent will consider each request individually to determine the desired amount of supervision required.  Salary for those supervising will be set by the Superintendent, and the body using the facility will reimburse the school for said salary.