Request Facility Use at Southmoore HS

Required

Organization, Group, or Individual Making this Requestrequired

Facility Requestedrequired

Practice Gym, Lecture Center, Commons Area

Date of Your Eventrequired

Must contain a date in MM/DD/YYYY format

Time of Eventrequired

Purpose of Requested Userequired

How many individuals are anticipated to attend the event?required

Responsible Individualrequired

First Name

Last Name

Phone Numberrequired

Email Addressrequired

The organization, group, or individual requesting use of an MPS facility agrees that he or she has the authority to bind the sponsoring group/organization or individual user to the following:required

1. Observe the rules and regulations for use of school facilities as outlined in MPS Policy #4160, Use of School District Facilities.

2. Assume full responsibility for loss of damage to school district property resulting from such use.

3. Assume full responsibility for personal injury or property damage sustained by any person as a result of such use, waive all school district liability for such injury and agree to hold the district harmless from any and all claims of whatever nature which may be brought against the district arising from the user’s use of the district premises.

4. Understand that no additional or other part or portion of the facility rented/used will be made accessible or available to the user.

5. Understand that no school equipment, storage spaces, or wall spaces will be accessible or available to the user.

6. Understand that proof of liability insurance is required prior to usage of a facility as stipulated in MPS Policy #4160, Use of School District Facilities.

7. Assume financial responsibility for rental fees, security fees, and any other required fees as stipulated in MPS Policy 4160, Use of School District Facilities

Usage of the facility is not finalized until both the Facility Approving Authority and the Director of Safety and Security approve the reservation and let the building Principal know to confirm with you.