905.01E1 - Request for Use of School Facilities

All officially sanctioned Maquoketa Valley athletics and activities will have priority over any other group wishing to use school facilities. This priority system also means that even after permission is given to an outside group to use a certain facility, that permission may be withdrawn at a later time due to unforeseen circumstances which necessitate the use of the facility by an officially sanctioned Maquoketa Valley athletic team or activity.
Team, Club, Organization or Individual Requesting Use of a Facility

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Facility/Facilities Being Requested Building

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What activity will be taking place during this event

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Date(s) the facility is being requested

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Time(s) the facility is being requested

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This request falls under the following category (Please Mark with an X)

____ Fundraising, Community Non-Profit Organization
-$50 for each use plus security deposit of $75 to cover any damage to the facility. Use of
school personnel will result in additional charges

____ Profit Making, Non-Community and/or Commercial Organization
-$125 minimum for each use plus security deposit of $75 cover any damage to the facility.
Use of school custodial/food service personnel will generally be required and result in
additional fees. (WILL REQUIRE SCHOOL BOARD APPROVAL)

____ Community Groups - General Use
-$20 per use (Maximum 4 hours) plus security deposit of $75 to cover any damage to
building. The deposit or any portion thereof not required for repairs or maintenance will
be returned.

____ Youth Athletic Tournament/Practice, 4-H, Scouts, Church Youth Groups, Adult Education
-No charge, but must meet all other requirements to use school facilities. Time spent by school personnel in extra cleaning will be billed to the sponsoring group. Any fees incurred for repair will also be billed to the sponsoring group.

It is agreed that the individual making this request is financially responsible to the Maquoketa Valley Community School District for any and all damages to the facility resulting from negligence or misuse.

Signature of Individual Making Request

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Address

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Telephone Number

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Date

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Rental Fee $

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Required Deposit $

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This activity DOES / DOES NOT meet the criteria for the benefit of Maquoketa Valley students and athletic programs, and the request for the use of the facility under the provisions of Board Policy 1004.012.

APPROVED DENIED

Activities Director:

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Date:

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