Single Use
Multiple Use
Enumclaw School District #216
District Building Facility Use Application / Agreement
E-mail: facility_use@enumclaw.wednet.edu Phone: 360-802-7100
User Group Name:
Today’s Date:
District Building / Facility Requested:
Classroom #
Library
Main Gym
Cafeteria / Multi-Purpose Room
Kitchen (Staff required)
Auxiliary Gym
Wrestling Room
Other
Responsible Person:
Billing Address:
E-mail Address:
Daytime phone:
Cell phone:
Times and Dates:
List all requested dates:
Time entering building:
Time leaving building:
Actual time of event:
to
Purpose:
Nature & purpose of use:
Required: Approx. # Attending:
Open to public?:
Admission/Participation Charge:
Y/N
Special Requests / Instructions: (Chairs, Tables, Hoops, Bleachers, etc.)
The undersigned has read and understands the Facility Regulations of this Facility Use Application / Agreement.
Applicant hereby agrees to abide by these regulations and all terms of this agreement, expressed or implied.
The representative signing personally guarantees payment for all invoices.
Applicant's signature
Title
Date
For Office Use Only
Facility Coordinator
Date
Building Principal
Date
Business Office
Date
Estimated Charges
Rental Fee:
Custodial Fee:
(per custodian)
Other Fees:
Restrictions/Comments
Hourly Rate
Required Items Checklist
Certificate of Insurance
Expiration Date:
Facility Use Terms of Agreement
Concussion Form
Est. Leasehold Tax:
(See Item 15, reverse side)
Approved
Less Deposit:
Disapproved