Name of Organization:
Hereby makes application for use of school facilities as follows:
Building / Room:
StadiumEMS AuditoriumHS AuditoriumHighschool GymPoolE/MS Cafeteria (dining area)Elementary/Middle Main GymElementary/Middle Aux. GymHS Cafeteria (dining area)Central Admin. Conference RoomOther, Please Specify Below
Specific Purpose of Use:
Will an admission fee be charged or a donation accepted?
NoYes If So, Amount
Equipment Requested:Stage Lights / OperatorLectern / PA system OperatorShowers - Dressing Rooms (Girls)Showers - Dressing Rooms (Boys)PianoTables/ ChairsAV Equipment / Operator
STATEMENT OF RESPONSIBILITY
I/We, the undersigned, have read the Northern Cambria School District's regulations concerning the use of school property and agree to assume the responsibility of any/all property damages incurred beyond ordinary usage. I/we assume all responsibility for any personal damage or liability incurred through use of he school facilities, and relieved the Board of School Directors from and responsibility for such claim.