Facility Use Request Form

Required

Organization Details

Is this an internal or external request? (internal: school event, external: non-school event)required

Internal Request

External Request

Name of Organization:required

Name of Person making request:required

Event Supervisor:required

Contact number(s):required

Contact Email Address:required

Request Details

Facility Requested:required

Explain in detail what the facility will be used for:required

How many people will be attending?required

Requested date:required

Must contain a date in M/D/YYYY format

Beginning Time:required

End time:required

Will you need to bring equipment onto the property? If yes, explain:required

How many folding chairs will you need? (Enter "0" if none are needed)required

How many tables will you need? (Enter "0" if none are needed)required

Signatures and Agreements

Custodial agreementrequired

I understand that charges will apply for any custodial staff present the day of the event.

BY ELECTRONICALLY SIGNING BELOW, I RELEASE ANY RIGHT THAT I MAY HAVE ON BEHALF OF MYSELF AND/OR ANTENDEES TO BRING LEGAL ACTION OR ASSERT CLAIM FOR INJURY OR LOSS OF ANY KIND AGAINST STRASBURG SCHOOL DISTRICT 31J. IF ANY ATTEMPT FOR CLAIM IS MADE, I UNDERSTAND I MAY BE HELD RESPONSIBLE FOR ALL DEFENSE COSTS INCURRED BY STRASBURG SCHOOL DISTRICT 31J.

I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THE ABOVE, BEEN GIVEN THE OPPORTUNITY TO ASK QUESTIONS, CONSIDER ITS EFFECTS, UNDERSTAND THIS ENTIRE DOCUMENT AND AGREE TO BE BOUND BY ITS TERMS. I further acknowledge that I am an official representative of the above organization and I am an authorized signer.

Electronic Signature of Requesteerequired

I understand and agree to the terms above

Today's Date:required

Must contain a date in M/D/YYYY format