83-733 Ave. 55, P.O. Box 847, Thermal, CA 92274
(760) 398-5909 Ext. 200
USE OF SCHOOL FACILITIES APPLICATION
|The undersigned hereby applies for use of school property for public purposes in accordance with Board Policy Number 1330, inclusive of Policies, Rules and Regulations of Governing Board.|
Click to download Board Policy 1330
Billing information required
PLEASE DESCRIBE THE EXACT NATURE AND PURPOSE OF YOUR GROUP
DESCRIPTION OF PROGRAM OF ACTIVITY:
|Is activity open to the public?:
|Will admission fees be charged?:
|Will contributions or other fees be solicited at the meeting?:
If charge is made or contributions are solicited, please describe the purpose for which money will be used:
If you are requesting more than one day, please complete the following:
Please attach Certificate of Liability or other insurance for the protection of the public and the District, as the District may require, and also submit an insurance declaration or endorsement identifying the Coachella Valley Unified School as an ADDITIONAL INSURED IN THE MINIMUM AMOUNT OF $500,000 Personal Liability (each occurence).
STATEMENT OF APPLICANT
Applicant hereby agrees to hold the Coachella Valley Unified School District, its Board of Trustees, the individual members thereof, and all District Officers, Agents, and Employees free and harmless from any loss, damage, liability, cost or expense that may arise during or be caused in any way by such use or occupancy of school property. I hereby certify that I will be personally responsible on behalf of the applicant for payment of all charges assessed for the use of the above premises and for any damages sustained by the school building, furniture, equipment, and or grounds accruing through the occupancy or use of said building and/or grounds by the applicant.
I, the requestor, hereby certify that I have read and agree to abide by the rules and regulations accompanying this application, as set forth in the policies of the board of Trustees and according to the laws of the State of California. NOTE: The person submitting this application and the statement above must be a member of the sponsoring organization. If the requestor is not an officer of the organization for whom the application is made, written authorization must be submitted from the applicant group to sign the foregoing application.
Please check equipment needed. (Equipment will NOT be provided unless it has been requested and approved in advance.)
Special Instructions, Arrangement of furniture, etc.
OFFICE USE - DO NOT WRITE BELOW THIS LINE
|Certificate of Insurance has been submitted: