SSD3 Application For Use of School Facility

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This form is a digital version of the paper form used for reserving the school for use by the General Public. Please complete this form to the best of your ability. By submitting this form you implicitly accept the terms listed in this agreement.

Email *

First and Last Name *

Phone Number of Responsible Party *

E-Mail Address *

CONDITIONS OF FACILITIES USE - Use of District facilities is conditioned upon the following covenants: Please check each box to indicate you understand the following covenants. *

1. That no alcoholic beverages, tobacco or other drugs are sold or consumed on the premises by the requesting organization or individual or any of its employees, patrons, agents, or members.

2. That no illegal games of chance or lotteries will be permitted.

3. That no functional alteration of the premises or functional changes in the use of such premises shall be made without specific written consent of the District.

4. The requesting organization/individual shall provide adequate supervision ensuring proper care and use of District facilities.

5. Unless otherwise authorized by law, no political activity will take place in a school facility and/or on school grounds.

Required

Phone Number *

Organization or Person requesting facility use: *

Address of Organization: *

Facility requested : *

Superior Elementary Gym

Superior High School Gym

Superior High School Multipurpose-room

Superior High School Commons

Health Enhancement Room (Weight Room) *Availible Hours 5pm-7am, 7 days a week

Old Junior High lot

Other:

Required

If you are requesting use of something other than the choices listed above, please describe your need and include its location:

Please Select A Starting Date: *

YYYY

Please Select an Ending Date: (Select the same date if the event is on the same day.) *if you are requesting weight room use leave blank *

YYYY

Facility Use Detail:

The time listed below will be constant for the entire event. If the event runs multiple days and the times are different for ending or starting on the second day, please contact the facilities use director.

Event Starting Time: * *

Time

Event Ending Time: * *

Time

Please select which doors you would like unlocked during the event: *

Elementary Main Front Doors

High School Main Front Doors

Multipurpose-room

High School Commons Door

HPE Weight Room

Required

Purpose of Use: * *

Will there be an admission fee on District property? If so how much?

Equipment or apparatus needed by user:

NOTICE:

(Requiring group is responsible for the set-up and return to original location of items. i.e. -chairs, overhead projectors, etc.)

Additional needs (if any):

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