Mt. Healthy CSD Facilities Use Form
This is the online form to request use of Mt. Healthy City School District facilities.  No commitments can be made until the completed form is approved by the Business Manager.
You must also upload the following documents: a completed and signed Facilities Use Agreement and a copy of Liability Insurance Carrier information.
Events may be canceled for any reason and at any time by the Business Manager/Facilities Manager.

To rent the auditorium is $150.00 per hour plus $30.00 per hour for sound/lighting and another $20.00 per hour for each custodian that needs to be there. Gym Rentals are $50.00 per hour for the Elementary Schools and $100.00 per hour at the Jr/Sr High School. The Certificate of Liability Insurance must also have Mt. Healthy City Schools on the certificate as additional insured in the amount of $1,000,000. All other rental fees will need to be discussed with our Business Manager.
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Name of group requesting facilities use *
Name of person filling out this form. *
Email addresss *
Phone Number *
Which building are you requesting use *
Which facility area of the building are you requesting to use? *
What is the reason for your request? *
Starting date *
MM
/
DD
/
YYYY
Time of use *
Time
:
Ending date *
MM
/
DD
/
YYYY
Time *
Time
:
What type of group are you? *
Who are the members of your group? (check all that apply) *
Required
Name (first and last) of the Responsible Party *
Address of the Responsible Party (includes city, state, and zip code) *
Liability Insurance carrier name (Please upload a copy of the insurance below) *
Please email the following documents.
You must email the following documents: a completed and signed Facilities Use Agreement and a copy of Liability Insurance Carrier information to districtrooms@mthcs.org
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