MCSD Facilities and Equipment Request
When filling out this form please provide as much information as possible about the rooms or equipment you are needing.
Please remember that school activities have priority over out of school activities.
Sign in to Google to save your progress. Learn more
Today's Date *
MM
/
DD
/
YYYY
Applicant First and Last Name *
Phone Number *
Email Address *
Request permission to use (specify classroom, gym, etc.) *
and (specify equipment, chairs, etc.)
at (name of school building) *
for (total # of hours)
start time
Time
:
end time
Time
:
start date
MM
/
DD
/
YYYY
end date *
MM
/
DD
/
YYYY
Day(s) of the week needed *
Type of Activity
Other notes/comments
The use of the Facility after hours or on the weekend requires a Custodian at the rate of $20.00 per hour
Clear selection
A Certification of Insurance is REQUIRED for non-school related functions. Is your certification of insurance on file at the school? Your request will not be approved until it is. *
Please send proof of insurance to amber.beaver@moffatsd.org
Request Agreement
We need fourteen days advanced notice of any requested activity to schedule the event. At least five days in advance of a scheduled program, a check to cover the services as stated should be made to the Board of Education, 775 Yampa Ave, Craig, CO 81625.  We agree to be jointly and severely responsible for any damage to property due to such occupancy other than reasonable wear and tear, and for the strict observance of rules and regulations prescribed by the Board of Education.  We agree to hold harmless the Moffat County School District for any liability due to our negligence that arises from our use of this facility.  We understand that the MCSD comprehensive general liability insurance does not extend to community or other groups using school facilities.  School Activities have priority over out of school activities.   *
Electronic Signature of Applicant *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Moffat County School District RE:1. Report Abuse