Buildings and Grounds Request
Waterloo Local Schools - 1464 Industry Road, Atwater, Ohio 44201
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Email *
Application Date *
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DD
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YYYY
Name of Organization *
Space Requested *
Required
Grounds/Outside Fields: Explain
Specific Dates Requested *
Begin/End Time: *
List in Detail the purpose for this space: *
Please list any equipment needed or required set-up: *
Activity Advisor or Person in Charge of the Group *
Your Address *
Phone Number *
Email Address *
By checking "Yes" you agree  to indemnify and hold harmless the Waterloo Local Board of Education and their agents and their employees from all liability, claims, damages, costs for, or arising out of this activity, whether it be caused by negligence of the indemnitor or the Waterloo Board of Education, either parties agents or employees, or any third party involved, participating, or attending the event or activity herein above identified.  I have read the rules governing the use of school property and hereby agree to all terms and conditions. *
Liability/Insurance Carrier - Outside groups must submit proof of $1,000,000 liability insurance policy with this application before this request is processed.  The right to cancel this permit at any time is reserved by the Waterloo Board of Education.  * Outside groups may be charged a facility use fee (for use of building outisde of normal custodials hours).
Enter your full name as this will signify a signature. *
A copy of your responses will be emailed to the address you provided.
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