REQUEST FOR USE OF SCHOOL FACILITIES

PORTA COMMUNITY UNIT SCHOOL DISTRICT #202

P.O. BOX 202, 17651 BLUEJAY ROAD, PETERSBURG, IL 62675

*** THIS FORM IS NOT USED FOR POOL RENTALS ***

Pool: $150 for first 2 hours, $75 per additional hour (includes one lifeguard & supervisor or manager, may require additional lifeguards at $15 per hour paid by the renter). Pool reservations can be made by contacting Rachel Frost at rfrost@porta202.org or 217-632-4745, Ext. 7.

TERMS OF FACILITY USE

The applicant and/or organization agrees to comply with all rules and regulations governing the use of school facilities within PORTA CUSD #202. The applicant shall provide the District with proof of insurance coverage and agrees to hold PORTA CUSD #202 harmless from any liability for injuries occurring during facility use, whether sustained by members of the applicant’s organization, District staff, or any other individuals. A current Certificate of Liability Insurance, with a minimum limit of $1 million, naming PORTA CUSD #202 as an additional insured on a primary and non-contributory basis, must be submitted and on file with the District prior to facility use.

The applicant agrees to assume responsibility for any damages to the premises or school property, as well as for any personnel costs (e.g., custodial services) incurred as a result of the organization’s use of the facility. The applicant further agrees to comply with all rules and regulations established by the administration. A $200 security deposit is also required and will be refunded after school personnel have inspected the facility and confirmed that no issues or damages have occurred.

Participants are prohibited from accessing any areas of the facility other than those specifically requested and approved through this application. All District or school functions take precedence over facility requests and will supersede any prior approval. The District reserves the right to modify, cancel, or revoke facility use requests at any time and for any reason deemed appropriate by the administration or Board of Education. Applications must be submitted no later than 14 days prior to the requested date of use.

The District reserves the right to priority booking when a non-school or community organization books a facility for an extended period of time (for example the gym every Sunday).

ALL EVENTS are required to have at least one PORTA Staff member in attendance. The hourly rate for the staff member in attendance will be charged at $35 per hour.

ACCEPTANCE OF TERMS *

Yes, I have read and agree to these Terms for Facility Use

APPLICANT DETAILS

Applicant Full Name *

Organization, if applicable

if a Community Organization is involved, please indicate that here

Applicant Phone Number *

Applicant Email *

Applicant Street Address *

City *

State *

Country

Postal Code *

EVENT TYPE / DATE / TIME

When providing your start and end times, be sure to include any time you need for set-up and clean-up.

For example:
Event is 5-7 pm. You want to access two hours early to prepare. You think it will take an hour to clean up afterward and be completely out of the space.

You should list your start time as 3 pm and your end time as 8 pm. Total time needed = 5 hours.

What is this event? Please describe how you will be using the space. *

Event Date *

Start Time *

End Time *

Total Hours *

Estimated Attendees *

Certificate of Insurance

If you don't have one yet, you may skip this upload. If space use is approved, you WILL need to provide one prior to Facility Use. Be sure to note minimum requirements in the Terms of Use section above

SPACE & EQUIPMENT REQUIRED

Building *

Area Needed *

If Other, please explain

School Equipment Needed

If Other, please explain

Custodian Required? *

Billed at $35/hour

STAFF INVOLVEMENT

ALL EVENTS are required to have at least one PORTA Staff member in attendance. The hourly rate for the staff member in attendance will be charged at $35 per hour. Please list the staff member who will be supervising the event. If you do not have a designated staff member selected and would like to request a staff member, please check the Staff Member Request box below. All approvals of facility requests will be subject to finding a staff member willing to attend the event.

Do you have a PORTA Staff Member participating? *

Billed at $35/hour (unless waived)

Name of Staff Member Attending

Staff Compensation Waived

Yes - staff agreed to waive compensation fee

No - staff has not agreed to waive compensation fee

Applicant Signature

Clear

*** IMPORTANT: READ BEFORE YOU SUBMIT***

When you click the submit button below, your request will be routed for appropriate approvals. Please note that each request requires review and approval by several team members. You will receive an immediate confirmation via email that we have received your request, but your request is NOT APPROVED until all of the necessary reviews have occurred. You will be notified when this process is complete.

If approved, you will need to submit:

a $200 check for security deposit
a check for staff/custodial compensation at $35 per hour (unless staff person has waived)
Certificate of Insurance (per the Terms at the top of this agreement).