Facility Usage

Facility Use Form


Name of Group or Individual:     Group or Individual Is:    If Other:   

Name of Representative:     Phone:     Email:  



Type of Property Needed:  Classroom    Playground    Cafeteria    Gymnasium    Kitchen Area   

                        Athletic Fields    Library/Media Center    Stadium    Hallway/Lobby

Name of District Site (if requesting a specific site):

Date of Requested Use:    

Time Building or Space is Needed:  : to :

Description and Purpose of Use:  



Groups and individuals may use desks, chairs and tables located in the room or facility designated for the individual's or group's use, but otherwise a permit to use district facilities doe not five permission for an individual or group to use district equipment, such as interactive whiteboards, computers, electronic equipment, projectors, kitchen appliances, scoreboards or athletic gear.  The superintendent of designee may provide access to equipment at his or her discretion and may charge a fee or a security deposit for use.

Both the Organization and I as the individual understand that district equipment cannot be removed from school property.  Both the Organization and I as an individual agree to exercise care in protecting school equipment and to prevent damage to school equipment.  In the event damage results, regardless of cause, the Organization and me as an individual agree to reimbure the district for the repair or replacement of the equipment at the district's discretion.

Please list any equipment needed:  

Security Measure