Form 172 - Facility Rental Application (Page 2 of 2) in pdf

Part II

Facility Procedures and Regulations

Applications for community use will be completed through the Office of Business and Finance. An electronic application will be

forwarded to the school of choice for approval or denial. Rentals are subject to the availability of staff as determined by GCA

Services.

The Office of Business and Finance will notify the organization as to the status of the application and to make arrangement for

payment of fees and insurance documents. Payment of fees at least two weeks prior to the date of use is required. Documentation of

non-profit status must be provided. Hampton City Schools retains the right to deny applications filed with the principal less than

fourteen days before the requested date of the use of property. Non-sufficient returned checks are subject to a $35.00 fee.

Organizations renting division facilities will be required to carry premises liability insurance for bodily injury limit per occurrence of

$1,000,000, and property damage limit per occurrence of $50,000 in order to afford some protection for citizens who might be injured

on school premises while attending or participating in functions by non-school groups. A certificate of insurance coverage will

accompany the application and the Board will be named as an additional insured. Certificates of insurance must be submitted to the

Office of Business and Finance on an annual basis.

The contracting party will agree:

To maintain, keep and leave the premises or areas, including any property adjacent to the school, in a clean, presentable

condition free from weeds, debris or other matter detrimental to the appearance of an educational institution.

To maintain proper safety measures and to prevent injury to any person or property as a result of the property use, and to save

the City of Hampton and the School Board harmless and free of damages by reason of that use, and to provide insurance by a

company licensed to do business in the State of Virginia. The contracting party will provide liability insurance for all

personal injury and property damages resulting from property use.

No permanent structure or equipment will be installed or removed, nor will there be placed or taken from the area any

material unless the written permission of the Superintendent is obtained.

To under no circumstance operate specialized equipment, such as lightening in the auditorium, as it is to be operated solely

by the named contact at the school.

Should the contracting party not follow all of the above covenants, the Board may cancel the agreement. The decision of the

Board is final.

In the event that schools close due to weather all community uses will be cancelled. The building principal reserves the right to deny

or terminate an application. Hampton City Schools reserves the right to terminate a contract if a violation of any local, state, or federal

law occurs.

I have read and agree to abide by the rules and regulations governing facility use in Hampton City Schools. I agree to be billed

for any incidental expenses that are utilized but not listed on this contract. If heating or air conditioning is requested the

organization will be required to pay an hourly fee beginning 30 minutes prior to occupancy.

Renter’s Signature:______________________________________________

Date: ___________________________________

Request Approved; no school function has been or will be planned that interferes with this rental request.

Request Denied, Give Explanation: _____________________________________________________________

Principal or Designee Signature: ______________________________________ Date: __________________________________

Staff members responsible for the event:

Name(s): _________________________________________________________________

GCA Designee Signature: ___________________________________________ Date: __________________________________

SBO Form 172 Reverse (Rev. July 2014)

Form 172 - Facility Rental Application Page 2