Groveport Madison Schools District Service Center 4400 Marketing Place, Suite B Groveport, OH 43125 614-492-2520 www.gocruisers.org

Facilities Use Request Form

Group Name: 	                     □Not-for-Profit	□For Profit

Person Responsible: 	 Phone #:

Address: 	 Email: 	

Event Description: 	

Building Requested: 	 Area/Room Requested: 	

Date(s) Requested: 	

Start Time: 	 Stop Time: 	 Estimated Attendance: 	

Custodial/Cook/Security Needs: 	

Special Arrangements/Requests: 	

The extension of the privilege to use facilities owned by the Groveport Madison Local Schools’ Board of Education is contingent upon the strict observance of, and compliance with, the rules and conditions attached to this form. The Board of Education is not responsible for accidents occurring from the use of said facilities.

SUBMIT THE COMPLETED COPY OF THIS REQUEST TO THE BUILDING PRINCIPAL/ADMINISTRATOR FOR INITIAL APPROVAL

INTERNAL USE ONLY
Custodian on Duty:	/ Charge /	Hours
a. __________________/_________/__________ a. __________________/_________/__________ a. __________________/_________/__________
Cook on Duty:	/	Charge /	Hours
a. __________________/_________/__________ b. __________________/_________/__________ c. __________________/_________/__________

Facilities Rental Charge: $
Reminder: Any HVAC, custodial, cook or security needs must be entered into the FMX system

I agree to assume liability for any damages or claims pursuant to the use of these facilities.

_____________________________	 ___ _______ Signature of Person Responsible                 Date Signed

_____________________________	____________ Signature of Building Administrator            Date Signed

_____________________________	____________ Signature of Deputy Superintendent         Date Signed

The mission of Groveport Madison Schools is to build a community of learners, leaders and responsible citizens. _______________________________________________

Every Student, Every Lesson, Every Day

Rules and Conditions for Community Use of School Facilities

The use of school premises by responsible organizations of the District for the welfare of the community and for promoting worthwhile activities is encouraged. Organizations requesting the use of school premises whose membership is predominantly within the District shall receive priority.

Priorities for the use of school premises should be as follows: (1) activities of students located in the attendance area being utilized, (2) activities of students attending another building in the District, (3) District clubs connected with the Groveport Madison Schools, such as band parents, athletic boosters, (4) community organizations, such as Scouts, Lions, Heritage Society, (5) private organizations.

Principals shall keep the District administrative office informed of all approved requests for the use of school premises by community groups, so that a master calendar can be kept up to date. In the event of a conflict, the Superintendent or his/her designee will decide on the organization to be approved for the use of facilities. Principals will establish regulations concerning the use of buildings after school hours by student organizations within the school.

The following rules shall be in effect when buildings or grounds are being used by community groups: A.	Smoking shall not be permitted in the schools or athletic fields.
B.	There shall be no alcoholic beverages brought to or consumed in the buildings or on the grounds.
C.	There shall be no food or drink made available or consumed in the auditorium commons area or the District auditorium. D.     Putting up decorations or scenery or moving pianos or other furniture is prohibited unless special permission is granted. E.	The applicant is held responsible for the preservation of order.
F.	Necessary police shall be on duty and paid by the applicant in advance of the use of the facility and a copy of a paid receipt shall be attached to the application. The need for police and the number needed shall be determined by the school authority granting the request and the police department being used.
G.     The school authority granting the request for the use of premises may require the attendance of custodial personnel and/or cafeteria personnel, as he/she deems necessary for the scheduled activity. Determination of need for these personnel is to be made in cooperation with the Director of Business Affairs, who shall then assign duty to the required personnel. The pay for personnel required will be included in the amount of the total fee for the use of the building. District staff or Board members who are members of a non-profit community group requesting use of school facilities may assume the responsibility for the organization, thereby limiting or precluding the need for paid personnel. However, such responsibility shall be voluntary in nature and cannot be provided when it is necessary to use school equipment, which requires a reasonable degree of expertise.
H.     When an organization is requesting the use of school premises for an activity that will result in the attendance of a number of children, the school authority granting the request may require the attendance of faculty members. The need for attendance of faculty members and the number needed will be determined by the school authority and will be based upon the type of activity and the size of anticipated attendance. The pay for the faculty members will be included in the amount of the total fee for the use of the building.
I.	The Board assumes no responsibility for properties left on the premises by the applicant.
J.	All electrical equipment and arrangements shall be in charge and control of the Board or its representatives. K.	The Board or its representatives must have free access to all rooms at all times.
L.	The gymnasium or any other room used by the applicant will be examined carefully after use and the applicant agrees to make good promptly any loss or damage occurring during the applicant's use of said room or rooms.
M. All requests for the use of a facility must be made in person no later than thirty (30) days in advance to the school official granting the request. An application for the use of the building and any custodial help needed shall be filled out and signed by the applicant with a check or money order (no cash) made out to Groveport Madison Local Schools for the cost of the use of the facility and custodial help at the time of application. The school official shall forward the application and fee to the Treasurer.
N.     If the applicant is requesting food from the cafeteria, an application must be filled out with the food service manager. The food service manager shall request a check or money order (no cash) for the full amount at the time of application. The application and fee amount shall be forwarded to the Treasurer.
O.     The right to revoke a permit at any time is reserved by the school official authorizing the permit. P.	All State and local fire regulations must be observed.
Q.     Gambling will not be permitted in school buildings or on District premises.
R.	Premises are rented with the understanding that "tipping" of custodians or other school personnel is not permitted. S.	Only the Groveport Madison Local Schools may pay employees for services involving the use of school facilities.

All requests for the use of District facilities/property by responsible school-related and non-school-related organizations are to be made through the principal/administrator of the facility involved.

Rev. 3/20/2019