Building/Grounds Use Permit

Building/Grounds Use Permit
Name of Organization
Contact Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Date of Event*

MonthDayYear
Date
Event Start Time*

Hour Minutes

AM/PM Option
Estimated End Time*

Hour Minutes

AM/PM Option
Purpose*
Room or Area to be Used
Send your request to:*

Director of Post-SecondaryDirector of Secondary
Rules
1. Users must comply with all applicable state/federal laws and school district policies.
2. Users are limited to restroom facilities and those areas stated on the permit.
3. Any damage to the building, equipment, or grounds will be charged to the permit holder.
4. The primary use of school facilities shall be for the district’s student educational program. A building use permit may be canceled if the facility is required for school use.
5. If the school’s kitchen is used, a school district food service employee must be present and have general supervision of the kitchen and kitchen equipment. The user is responsible for payment of the employee, with the fee being paid to the treasurer.
6. The user will be responsible for cleaning the area used and leaving it in a condition acceptable to the school official.
7. Extra costs, including labor costs for special services performed by school district employees, will be charged to the organization when such services are required. The user will pay a fee at an hourly rate for the use of facilities or grounds and an additional hourly fee for services performed by school personnel if needed. The fee will be paid to the school immediately following an inspection of the facility.
8. The school district will not assume any responsibility or liability for any injuries or damages received by an individual or individuals participating in activities sponsored by the user.
9. The principal and or superintendent may revoke a use permit for violations of any rules or for any other reason deemed necessary to protect the building, equipment, or school district from possible damages.
10. The school district may deny the use of any building or facility at its discretion. A school official may deny the use of any area of a particular school plant at his/her discretion.
I HAVE READ THE STATED RULES FOR A BUILDING/GROUNDS USE PERMIT AND DO AGREE TO SAID RULES, AND FURTHER AGREE TO ACCEPT FULL LIABILITY FOR ANY INJURIES OR DAMAGES RECEIVED BY AN INDIVIDUAL OR INDIVIDUALS ON THE FACILITY PREMISES SPONSORED BY THE USER AND DO AGREE TO SAID RULES.
Signature*

Clear
Should be Empty:

Building/Grounds Use Permit

Rules