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AUGUSTA
USD 402 Public Schools
USD 402 Public Schools
District
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Facility Rental Information
Facilities Rental Request Form
Facilities Rental Request Form
Please Fill Out The Facilities Rental Request Form Below
ALL CONTACT REGARDING FACILITY USAGE REQUESTS WILL BE MADE THROUGH THE ADMINISTRATION OFFICE, 2345 GREYHOUND DRIVE, AUGUSTA, KS. PLEASE NOTE: ALL DISTRCIT FACILITIES ARE LATEX FREE, NO LATEX IS ALLOWED. USERS WILL AGREE TO COMPLY WITH ALL STATE AND FEDERAL LAWS AS IT RELATES TO FACILITY USAGE.
I agree to not use latex and abide by all State and Federal laws as it relates to facility usage.
REQUESTED BY: Name of Individual Handling Request
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ORGANIZATION:
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Facility Requested:
Request for waiver of fees
AHS Auditorium $100 +custodial/lighting
Lighting operated through control panel (Hourly wage of operator)
Special lighting $15/hour for operator
AHS Gymnasium $75 +custodial/managerial
AHS Commons $50 +custodial/managerial
AHS Commons with kitchen $75
AHS Commons with kitchen & kitchen equipment $75 +hourly rate of food service management company
AMS Gymnasium $75 +custodial/managerial
AMS Commons $50 +custodial/managerial
AMS Commons with kitchen $75 +custodial/managerial
Elementary Multi-Purpose Room $50 +custodial/managerial
Elementary Multi-Purpose Room with Kitchen $75 +custodial/managerial
Public Address System $25
IF REQUESTING THE USE OF AN ELEMENTARY SCHOOL, WHICH ONE?
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LIST EACH AREA OF BUILDING, AND EACH INDIVIDUAL ROOM(S) BEING REQUESTED:
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EQUIPMENT NEEDED (i.e., chairs, tables, lights, sound system, etc. ):
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LIST ALL ACTIVITIES TO BE HELD IN FACILITY:
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IS THIS A FUND RAISING EVENT?
NO
YES
ESTIMATE NUMBER OF PEOPLE ATTENDING:
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DATE YOU ARE REQUESTING USE OF FACILITY:
Calendar
IS YOUR EVENT FOR MORE THAN ONE DAY?
NO
YES
ENDING DATE OF FACILITY USAGE:
Calendar
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LIST STARTING AND ENDING TIME OF EACH USE AND INCLUDE SET UP TIME, IF ANY:
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ESTIMATED CHARGES FOR USE OF DISTRICT FACILITIES:
I understand that this is just an estimate
APPROVAL BY BUILDING ADMINISTRATOR
APPROVED BY _____ BOE
LIABILITY INSURANCE
RENTAL
CUSTODIAL/MANAGERAL
LIGHTING
LIGHTING OPERATOR
OTHER ESTIMATED EXPENSES
TOTAL
A FINAL COST STATEMENT OF ACTUAL COSTS WILL BE SENT UPON COMPLETION OF ACTIVITY.
I understand that a final cost statement will be sent upon completion of activity
WE AGREE TO PAY ANY RENTAL AND CUSTODIAL FEES FOR USE OF THE SCHOOL FACILITY ESTABLISHED BY THE BOARD OF EDUCATION.
Please check upon agreement
DATE
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SIGNATURE OF RESPONSIBLE PARTY
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