JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
HUUSD Building Use Application
INSTRUCTIONS:
*Please complete the required fields below and submit at least 10 working days before your event.
*Additional documents (certificate of insurance, Hold Harmless statement, non-profit status) may be required; you will be notified of required documents after submitting this initial request.
*Public events with anticipated attendance of 100 or more may require you to secure security services.
PLEASE NOTE THAT THIS IS NOT A CONTRACT. Submission of this application does not guarantee approval. A contract will be provided upon approval.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name of individual responsible for event:
*
Your answer
Contact person, if different from above:
Your answer
Organization:
*
Your answer
Mailing Address (street, city, state, zip):
*
Your answer
Telephone Number(s):
*
FORMAT: XXXXXXXXXX (NO dashes)
Your answer
School Requested:
*
HUHS/HUMS
CBMS
Fayston Elementary
Moretown Elementary
BPS (formerly TBPS)
Waitsfield Elementary
Warren Elementary
Requested School Area:
*
On behalf of the individual or organization above, I hereby request permission to use the following area(s) of the school:
Classroom
Gym
Cafeteria
Kitchen
Conference Room
Library
Other:
Required
Date(s) I am requesting this building use:
*
Your answer
Event Start Time:
*
Time
:
AM
PM
Event End Time:
*
Time
:
AM
PM
Setup Start Time:
*
Time
:
AM
PM
Setup Completion Date:
*
MM
/
DD
/
YYYY
Setup Completion Time:
*
Time
:
AM
PM
Event type/description:
*
Your answer
Is your organization charging a participant/admission fee?
*
Yes
No
If yes, amount?
Your answer
Guest Speaker Name (if applicable):
Your answer
How many attendees do you expect at this event?
*
Your answer
I need the following equipment supplied for this event:
*
Chairs, tables, podiums, sound system, overhead projector, screen, TV/VCR/DVD, etc.
Your answer
I need custodial coverage for our event:
*
Yes
No
I need food services personnel coverage for event:
*
Yes
No
Who will be participating?
*
Youth
Adults
If youth, will this activity serve HUUSD students?
Yes
No
Clear selection
If adults, will this serve:
HUUSD staff
HUUSD community members
Other:
Clear selection
We are a certified NON-PROFIT Organization:
*
Note: Non-profit status needs to be proven through a valid 501(c)(3) certificate. If the organization or person is a FOR-PROFIT Organization, a copy of personal or corporate liability insurance must be provided prior to your scheduled event. For more information, call your insurance agent directly.
Yes
No
I have arranged for a sheriff or security officer to be present on-site at all times.
*
At the discretion of the school Administration, security may be required. Attendance of 100 or more may require security services.
Yes
No
N/A
Representative Agreement:
*
I agree to the following rules and regulations (please check that you agree to ALL).
Any organization using the building shall leave the facility in the same order as found. Additional charges will be assessed and future use by an organization may be limited if violation of this rule occurs.
No smoking or vaping anywhere, including in vehicles on school property.
Drinking of alcoholic beverages and use of illegal drugs on school premises is prohibited.
Do not move furniture or equipment belonging to the school without permission. Anything moved needs to be returned to its original location.
Alterations/additions to school property are prohibited.
Participants will not be restricted from participation for reasons of race, religion, gender, sexual orientation, creed, national origin, or disability.
Required
Our organization will abide by all state COVID-19 recommendations for safety and health.
*
Yes, I agree
Required
Organization Memorandum of Understanding
*
As the organization representative, I have read and understand all school/facility use rules and regulations and agree to adhere to them. I also agree to enforce the rules and regulations with my membership and event participants. I realize that failure to enforce or follow the rules will result in immediate suspension of building/facility use. I understand that I may not transfer or assign this agreement or sublet any part of said premises without express written consent from the Facility Use Coordinator. This form must be completed one week before use. A deposit of 50% of anticipated charges is due upon completion of this contract. The final balance is due within seven (7) days of receipt of the final invoice. By checking yes below, you cite that you agree with the above statement and have fully read the Harwood Unified Union School District Procedures For Use Of School Facilities document found here ->
https://goo.gl/VeUzgf
Yes, I agree
Required
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Harwood Unified Union School District.
Report Abuse
Forms
