La Center School District No. 101
725 Highland Road / PO Box 1840
La Center, WA 98629
Phone: 360-263-2131 / Fax: 360-263-1140

Agreement for Use of School Facilities

The following conditions and regulations shall apply to any Use of School Facilities:

• School Facilities Use Forms needs to be filled out completely before any request(s) can be considered for approval.
• The school district has 48 hours before approving/denying your requested date(s). This is to determine if facilities requested are available.
• School District activities will take presidence in scheduling over community activities. The school district reserves the right to cancel your requested date(s) if a school activity needs to use that date/time/location. We will try our best to avoid this situation and if it does occur we will reschedule with you at your earliest convenience.
• All groups will need to provide Certificate of Liability Insurance or go through La Center Community Education to be covered under their insurance.
• Payment of any fees or charges is to be made ahead of time, unless specific arrangements are made with the Community Education Director or the Business Office.
• Any group or individuals using the facilities accepts responsibility for any fines or fees, assessed to the district, or damages done to district property, as a result of their use of the the facilities, and shall reimburse the district for any such fines, fees, or damages.
• The applicant agrees to clean and restore the area used to its original condition, unless other arrangements have been made and agreed to ahead of time.
• The steam cabinets are not available for use.
• Only the facilities requested on this agreement will be used by the applicant.
• The use of/or possession of tobacco, alcohol, illegal drugs or firearms are not permitted at any time on school grounds.
• Applicants accept responsibility for the strict enforcement for these regulations.
• The School District reserves the right to cancel at any time the event listed on this agreement.
• Applicants agree to protect and indemnify the district, its officers, directors, and agents from any and all claims, suits, legal fees, and other liabilities relating to or arising from acts or omissions of such groups or individuals in connection with the use of said facilities.
• Applicants agree to notify the district, immediately, if they find any area of the facility and/or equipment in disrepair, or left in any way which may result in injury to persons or additional damage to the facility.

Applicant's Name / Group		Today's Date
Date(s) Requested		Campus Requested	K-8 Campus High School District Office
Area or Specific Space Requested	District Office Conference Room Elementary ASK Room Elementary Classroom Elementary Gym High School Band Room High School Baseball Field High School Challenge Course High School Classroom High School Commons High School Conference Room High School Concession Kitchen High School Football Practice Field High School Gym High School Kitchen High School Library High School Parking Lot High School Portable High School Soccer Practice Field High School Stage High School Track High School Weight Room K-8 Community Kitchen K-8 Computer Lab K-8 Entry Way K-8 Football Field K-8 Library K-8 Play Shed K-8 Softball Field Middle School Classroom Middle School Conference Room Middle School Gym Other
Time Start		Time End
Set-up Time (If Needed)		Breakdown Time (If Needed)
Brief Description of Event to Take Place		Approx. Number of People Attending
Is Event Open to the Public?	Yes No
Does your organization hold non-profit status?	Yes No
Is this a revenue generating event?	Yes No
If you are requesting use of a field, would you like to be notified of any chemical spraying that is scheduled for that filed during your requested time?			Yes No
Contact Person		Email Address
Home Phone		Alternate Phone
Mailing Address		City
State		Zip Code
May we put this contact person's name, phone number and/or email address on the website calendar as the contact person?		Yes No
I , have read, agree to, and have the authority from the requesting group to agree to all of the terms and conditions
specified in this agreement and by so doing verify that all information given is accurate and correct.
Submit
LabelFor Office Use Only
	Fee	Account Code
Community Education Fee	____________________	_______________________
Field & Maintenance	____________________	_______________________
Incidental Fee	____________________	_______________________
Key Deposit Fee	____________________	_______________________
Other Fee	____________________	_______________________
Rental Fee	____________________	_______________________
Total Fees	____________________ Paid in Full Cash	Check ________Check #
Departments whom have been notified of event		Date Notified ___________________
_____ ASK	_____ Custodians/Maintenance	_____ High School Library	_____ K-8 Library
_____ Athletic Director	_____ Elementary Office	_____ High School Office	_____ Middle School Office
_____ Community Education	_____ High School Cafeteria	_____ K-8 Cafeteria	_____ Other
Approved By ____________________________________ Denied By _____________________________________		Date ________________________________________
Reason Denied _____________________________________________________________________________________
Entered onto web calendar __________________