83-733 Ave. 55, P.O. Box 847, Thermal, CA  92274
(760) 398-5909 Ext. 200
USE OF SCHOOL FACILITIES APPLICATION

Billing information required

PLEASE DESCRIBE THE EXACT NATURE AND PURPOSE OF YOUR GROUP

DESCRIPTION OF PROGRAM OF ACTIVITY:

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:

INSURANCE REQUIREMENT

As a condition for use of the facility, the Applicant shall procure Commercial General Liability (“CGL”) Insurance acceptable to Coachella Valley Unified School District, naming Coachella Valley Unified School District as a “Named Additional Insured”, with respects to any liability (for personal injury, bodily injury, contractual liability, and damage to property sustained) arising out of the Applicant’s acts, activities, use, or obligation under this Agreement. Please attach a Certificate of Insurance and Additional Insured Endorsement naming Coachella Valley Unified School District as Certificate Holder and Additional Insured in the minimum amount of $1,000,000 General Liability (for each occurrence).

**Please note, CVUSD reserves the right to adjust these limits at any time.

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.

EQUIPMENT REQUIRED

Please check equipment needed. (Equipment will NOT be provided unless it has been requested and approved in advance.)

Special Instructions, Arrangement of furniture, etc.