Policies » Section K: School/Community - Home Relations » KF-P: Application For Use Of School Facilities

Policy Date: 01/12/2021

AUBURN SCHOOL DISTRICT
APPLICATION FOR USE OF SCHOOL FACILITIES

The undersigned accepts responsibility for seeing that all rules regulating the use of facilities are followed and shall be responsible for any damages resulting from the use of the facilities and agrees to defend, indemnify and hold harmless the Auburn School District, its officers, agents and employees for any property damage or injury occurring during or as a result of the event. Payments, if any, should be made payable to Auburn Village School and included with the application in this form of a check or money order.

Today’s Date:________

Name of Organization and Title of Event: __________________________________________

Name of Person Requesting the Facilities: __________________________________________

Address: _________________________________________________________________

Email: ___________________________________________________________________

______ Non-Profit Organization OR  ______For-Profit Organization or Private Group

Signature: ____________________________________ Telephone Number: ______________________

Access to the facilities will be required on:

Date_________ at (Time) _________to set up

Date_________ at (Time) _________ for the event

Date_________ at (Time) __________ to clean up

Facilities being requested:

Gymnasium (Capacity 450 with chairs,
300 with tables)…………………..       _____________

Platform (Capacity 85) (no permanent props)… __________

Band Room ………………………… _______

Media Center ………………………. _______

Cafeteria (Capacity 150 with tables)
– does not include kitchen and equipment-…………………..…………… _________

Kitchen* (equipment)……………… _________

Food Service Director must be contacted immediately if this line is checked. The using organization shall assume the cost incurred from the use of the kitchen.

Unlock Building …………………….. ________ Lock Building ……………………… ________

Equipment needed:

Cafeteria Tables…..________ Easel…..________ TV/VCR…..________Overhead Projector…..________

Chairs (how many)…..________ Microphone…..________ Screen/Projector Use….._____ Misc. (specify)….._____

Facility Utilization Fees – TOTAL:___________

Opening $40

Gymnasium $100

Cafeteria $100 Rubbish Removal $20

Closing $40

Media Center $70

Cafeteria/Kitchen $150

Classrooms $50ea

Ball Fields/Grounds $100

Cleaning/Damage Deposit $100

Other:______________________

Deposit:_____________________

Approved by:________________________ , Principal or designee        Date:__________________

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