THE ADMINISTRATION IS RESPONSIBLE FOR THE USE OF ALL SCHOOL FACILITIES. IN ORDER THAT THEY MAY CONSIDER YOUR REQUEST FOR THE USE OF SCHOOL FACILITIES, KINDLY COMPLETE THE FOLLOWING FORM AND RETURN IT TO THE SCHOOL AT LEAST ONE WEEK IN ADVANCE.

FRIENDSHIPCENTRALSCHOOL

FACILITY USE REQUEST

______requests the use of ______

Person/Organization Room(s) or Facility

for the purpose of ______on ______

Date (s)

From ______to ______

timetime

Approximate number of participants:______Will admission be charged? YES _____ NO _____

Will activity be open to the public? YES _____ NO _____

Will donations be accepted? YES_____ NO _____ If yes; for what purpose will proceeds be used?

______

______

Request for additional equipment i.e. chairs, tables, public address:

PERSON RESPONSIBLE

Name ______Name______

Print or TypeSignature

Address ______Phone Number ______

______

Note: Applicant must read and sign “Rules Governing Facility Use”. Completed

Application) should be submitted to the Superintendent of

Schools at least one (1) week prior to expected use.

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INSURANCE INFORMATION:

Do you (the requesting organization) have a comprehensive general liability policy?

YES _____ NO _____

If yes, please include a certificate of insurance form from your insurance agent. Include FriendshipCentralSchool as certificate holder and as additional named insured. ($500,000 required minimum limit of liability.)

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RULES GOVERNING USE OF FACILITIES BY COMMUNITY GROUPS:

1)No tobacco products allowed on the school property.

2)No drinking of alcoholic beverages or use of illegal drugs permitted.

3)The activity shall be restricted to that area for which permission is granted.

4)All programs shall be so planned that they do not interfere with the regular school schedule.

5)The organization using the building shall be responsible for getting its equipment in and out of the building.

6)The supervisor in charge of the activity shall be present before the activity is due to start and remain with the group until all have left.

7)In the absence of the building principal or administrative personnel, the custodian is charged with the responsibility of the building.

8)Any loss or damage occurring to property loaned shall be charged against the sponsoring group.

9)No school property or equipment is to be altered or removed from the premises.

10)Players can wear sneakers, molded cleats, or turf shoes only. No metal spikes or screw in cleats are to be worn in the building.

11)Spectators are not to be on the playing fields during games.

12)This request is revocable at any time without notice.

SIGNED______DATE ______

(Requesting Organization Representative)

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Comments (school personnel only) ______

______

______

(DIS) APPROVED ______DATE ______

(Athletic Director)

(DIS) APPROVED ______DATE ______

(Music Dept)

(DIS) APPROVED ______DATE ______

(Head of Custodians/Maintenance)

Custodial Needs:

Number of hours ______@ $25/hr = ______

(DIS) APPROVED ______DATE ______

(Building Principal)

(DIS) APPROVED ______DATE ______

(Superintendent of Schools)