Gilpin County School District RE-1
School Building Use Application
Application Date
*
-
Month
-
Day
Year
Date
Name of Group or Organization
*
Outside of School Group/Organization For-profit or Non-profit Status
*
Please Select
School Group
For-profit
Non-profit 501(c)(3)Status
Outside of School Group/Organization $1 million Certificate of Insurance
*
Please Select
Does not apply to the current applicant group.
Yes. We have this insurance policy.
No. We do not have this insurance policy.
Name of Applicant
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First Name
Last Name
Point of Contact Email
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Point of Contact Telephone Number
*
Purpose of Use
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What date(s) will the room(s)/area(s) be needed
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Please use mm/dd/yyyy
Which day(s) of the week does the event take place on
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What room(s) or spaces are requested for the event (Activity and Athletic Event Field and Track, Auditorium, Cafeteria Seating Area, Classroom, Elementary Library, Elementary Multipurpose, Kitchen, Meeting Room, Secondary Library, New Gym, Old Gym, Parking Lot, Other). Provide detailed description.
*
If you have equipment requests please list them below (Tables, chairs, podium, microphone, projector).
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Submitting a request for equipment is not a guarantee that items will be available or approved for use. I understand I am responsible for any and all equipment provided to me. If items or damaged or lost I may be asked to replace or pay for the damaged/missing items.
I understand there may be a fee charged for the use of the building and/or equipment.
*
Yes
No
For more information on fees, click the link below.
Fee Schedule and Information
Please indicate the time that individuals will arrive to start preparations or time you will need the space to be available.
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Hour Minutes
AM
PM
AM/PM Option
What time does the event begin?
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Hour Minutes
AM
PM
AM/PM Option
What time will the event end?
*
Hour Minutes
AM
PM
AM/PM Option
Please indicate the time that all organizers will depart the building.
*
Hour Minutes
AM
PM
AM/PM Option
District Designee/Representative (Must be present at event)
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First Name
Last Name
Telephone Number for District Designee
District Designee Email
*
Please briefly tell us how security will be handled for the event. If none you may respond with N/A
Number of anticipated adults?
Number of anticipated children?
What will be the supervision/childcare arrangements for the event?
*
I understand by signing and submitting this Building Use Application, that I will be held responsible for any damages to the building and/or equipment/items located in the area(s) of use.
*
Yes
No
N/A
Signature
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: