SSD Facility Use Request
Please make facility requests as soon as possible. School activities take precedence.
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Name of Organization *
Today's Date *
MM
/
DD
/
YYYY
Type of Organization *
Contact Number (xxx)(xxx-xxxx) *
Contact Person *
Address *
Purpose of Use *
Admission Charged? *
Requested Date(s) *
Start Time *
Time
:
End Time *
Time
:
Building Requested *
Area Requested, Equipment & Personnel Requested (Check All that Apply) *
Required
Additional Information
The above name contact person has responsibility for supervision of the group and proper maintenance of the facilities and equipment. At least one adult must be present during the entire time the facility is used. To support the request to rent/utilize property of the Seneca Area School District set forth above, I (applicant or authorized agent of applicant) hereby agree as follows:  To abide by the rules and regulations of the school district governing the use of school facilities, and to see that such rules and regulations are complied with and obeyed by others; to assume responsibility for and to make restitution for any damage to the building or equipment during the period of rental/use which in the judgment of the school district constitutes damage or destruction beyond normal wear and tear and intended usage; and to indemnify and forever hold harmless the school district and its officers, agents, and employees, from any and all claims of any kind, nature or description arising out of the use of any of the school facilities pursuant to this application or any modification thereof.          ** I REPRESENT AND UNDERSTAND THAT I AND/OR THE ENTITY FOR WHICH I AM AUTHORIZED AGENT AM, AND WILL BE, FINANCIALLY RESPONSIBLE AND LIABLE FOR ANY PROPERTY DAMAGE OR PERSONAL INJURY ARISING OUT OF RENTAL/USAGE OF SAID FACILITIES.  TYPE YOUR NAME BELOW SIGNIFYING YOUR ACCEPTANCE OF THESE TERMS. *
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