Bridgman Public Schools–Facility Forms

BRIDGMAN PUBLIC SCHOOL DISTRICT

Request For Use of School Facilities

Group making request:  _______________________________________________________________________

Contact Person:  ___________________________________           Phone #:  ______________________________

Room/Area to be used:  _______________________________________________________________________

Purpose of facility use:  _______________________________________________________________________

Date(s) and time facility will be used:  ____________________________________________________________

__________________________________________________________________________________________

Name of adult in charge:  ________________________________        Phone #: _______________________

              Address:               _________________________________

If special equipment is needed, please list below:

___________________________________________________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

Anticipated number of people attending:  __________________________

Cost of Admission:           $ ______________

The applicant has received and read the regulations for the use of school facilities.  The applicant hereby agrees to indemnify and hold harmless the Bridgman Public Schools from any liability for damage to any person or property in or about the School District premises from any cause whatsoever.  All persons or groups using school facilities shall be responsible for the proper supervision, control and accommodation of persons attending the activity.  The applicant agrees to be responsible for the preservation of order.  All advertising that is religious in nature must contain the disclaimer, “This event is not endorsed by the Bridgman Public Schools.”

Applicant:            _________________________________________                            _______________________

                            Signature                                                                                                Date

FOR OFFICE USE ONLY

Fees are as follows:         Rental Fees                 $ _______________

                                          Technical Fees        $ _______________

                                          Custodial Fees         $ _______________

                                          Key Deposit             $ ___$20.00___

                                          Other                       $ _______________

                                          ** No Fees                  _______________

                                          FEE TOTAL             $ _______________

If payment is due, checks should be made payable to:  Bridgman Public Schools.  If no payment is due, return this form to the school.

Your request for facility use has been:        Approved                        Denied

_____________________________________________________                        _____________________________

Signature of Principal                                                                                           Date

FEE FOR USE OF DISTRICT BUILDINGS

A schedule of fees for the use of District facilities is determined annually based upon the following factors:

A.     The use of District facilities for activities related to the educational program and District operations shall

        be without cost to the users, except that the users shall be responsible for any police fees.

B.     The use of District facilities for any nonprofit community use shall be without cost to the users except that the users

        shall be responsible for any extra custodial and cafeteria employees fees, police fees, and snowplowing fees.

C,     A ll other organizations or persons granted the use of schools shall assume the following charges as indicated,

        payable in advance, and the cost of such additional staff services as may be required.

Elementary/Middle Schools                                                               Charges

All-Purpose Room (Gymnasium-Auditorium)                                           $15.00/hour

Lunchroom                                                                                          $10.00/hour

Lunchroom and Kitchen with refreshments                                              $10.00/hour

(School lunchroom worker’s presence required,

if equipment is used, at established rate)

Lunchroom and Kitchen, with meal                                                         $10.00/hour

(School lunchroom worker’s presence required

at established rate)

Library, Classroom, or Teacher’s Lounge                                                $8.00/hour

High School                                                                                           Charges

Auditorium                                                                                               $30.00/hour

Classroom                                                                                               $8.00/hour

Athletic Field                                                                                           $30.00/hour

Gymnasium                                                                                             $15.00/hour

Lunchroom                                                                                              $10.00/hour

Lunchroom and Kitchen with refreshments                                                  $10.00/hour

(School lunchroom worker’s presence required,

if equipment is used, at established rate)

Lunchroom and Kitchen, with meal                                                             $10.00/hour

(School lunchroom worker’s presence required

at established rate)

Library or Teacher’s Lounge                                                                       $10.00/hour

FOR OFFICE USE ONLY

  Copies To:

  Building & Grounds Director                    Day Custodian                Other: ___________________

                              Athletic Director                         Night Custodian

                              Auditorium Director                    Media Center

                              Food Service Director                 Tech. Department