Agreement # ____________________

EVERETT PUBLIC SCHOOLS

REQUEST TO USE SCHOOL FACILITY

(A copy of this form and applicable fees can be obtained from www.everett.k12.wa.us/communityservices )

CIVIC AUDITORIUM

MEMORIAL STADIUM/LINCOLN FIELD

*LONGFELLOW/ESC BUILDING

SERVICES (pending availability)

(hereafter referred to as “User”), agree that the information on

a private non-profit youth sports group, verifies all coaches, athletes

1. The Request to Use a School Facility form, Certification Form, rental/monthly fees, and insurance are due two weeks prior to the first date of the event.

2. Written notice of cancellation must be given at least two weeks prior to the scheduled rental date.

3. Staff overtime will be billed to User; charges must be paid within two weeks after the invoice date.

4. If User plans to utilize the kitchen facilities, User will need to contact the Food and Nutrition Services two weeks prior to the event at (425) 385-4250.

5. User will be held responsible for costs of repair for damages, as determined by the Everett Public Schools.

6. User will provide proof of required assets and proposed insurance as follows:

A. Limits of General Liability: $1,000,000 Combined Single Limit per occurrence.

B. A certificate of insurance naming Everett Public Schools as additional named insured must be received by Everett Public Schools at least two weeks before facility use begins.

C. If self-insured, User must provide proof-of-insurance coverage acceptable to EPS for the purpose of the rental.

7. The following person/organization will be responsible for payment of all charges and damages:

8. All usage shall conform to requirements set forth in the Uniform Fire Code. User shall restrict attendance to the facility’s assigned occupant load. Section 4.108 of the U.F.C. states that any candle or open flame used in assembly requires a permit from the Everett Fire Department at (425) 257-8120. A copy of any permit issued must be on file with Everett Public Schools two weeks prior to event. All facility use outside of the City of Everett boundaries shall strictly adhere to Section 4.108 of the Uniform Fire Code. Violations shall be deemed a misdemeanor and shall be punishable by a fine of not more than $1,000 or not more than ninety days in jail.

9. User will be held responsible for supervision and control of all individuals present during the time of the facility use. User is responsible for complying with any and all security requirements of the local police jurisdiction. Animals are not allowed inside EPS facilities. Alcohol, tobacco and firearms/weapons are prohibited on all EPS property.

10. User must comply with all federal, state and local laws prohibiting discrimination with regard to creed, race, color, sex, sexual orientation, marital status, veteran status, age, national origin or disability.

11. User agrees to notify the EPS's technician or custodian of any accidents immediately and file an EPS Accident Report.

12. User is responsible for all copyright or royalty compliance and fees associated with this activity.

13. User is responsible for obtaining all necessary permits for the activity. Such permits must be presented to EPS for inspection at least 14 days prior to the event or the event may, at the sole discretion of EPS, be canceled. In such a case, EPS will refund to User any deposits paid, less the current scheduling fee.

AGREEMENT TO CONDITIONS, INDEMNIFICATION, AND CERTIFICATION

As a material consideration to Everett Public Schools ("EPS") granting User's request, and without which EPS would not do so, User agrees to and does hereby indemnify and hold harmless EPS, its directors, employees, agents, and volunteers, from any and all claims, demands, suits, actions, losses, liabilities, damages,expenses, costs, or attorneys' fees, directly or indirectly attributable to User’s activities and/or use of EPS's premises in connection with this agreement, except for damages caused by the sole negligence of EPS, its directors, or its employees and agents acting within the scope of their employment.

User also certifies that copy of District Policy 4333 has been provided, the information provided on this request is true and complete and agrees to abide by the conditions set forth above and by District policy 4333

Ø USER SIGNATURE:

DATE:

CONFIRMATION BY DISTRICT: _______________________________________ DATE: _____________________

Cascade High School Everett High School Jackson High School Sequoia High School Eisenhower Middle Evergreen Middle Gateway Middle Heatherwood Middle North Middle Cedar Wood Elem. Emerson Elem. Forest View Elem. Garfield Elem. Hawthorne Elem. Jackson Elem. Jefferson Elem. Lowell Elem. Madison Elem. Mill Creek Elem. James Monroe Elem. Penny Creek Elem. Silver Firs Elem. Silver Lake Elem. View Ridge Elem. Whittier Elem. Woodside Elem. Lively Environmental Center	Library Faculty Lounge Classroom # Cafeteria/Commons Kitchen—[see back; #4] Rubber Room Aux. Gym Main Gym Locker Room Track Field w [i.e., football] Tennis Courts Parking Lot Wrestling Room EHS Little Theatre	1,534 occupant load 1,480 occupant load (with orchestra area cleared)



		MEMORIAL STADIUM/LINCOLN FIELD
		Memorial Stadium Track/Football Facility Memorial Stadium Baseball Facility Memorial Stadium Practice Field (grass) Memorial Stadium Locker Rooms Lincoln Field Soccer/Track Lincoln Field Softball Lincoln Field Concessions Stands






		*DISTRICT USE ONLY:
		*LONGFELLOW/ESC BUILDING
		Large Annex Small Annex C1 C3 Board Room

		SERVICES (pending availability)
		Qty. Item Qty. Item Podium Piano Table Sound Shell(Auditorium only) Microphone(s) Band Riser (Auditorium only) Chairs Other (i.e., lights, etc.) Marley Floor Bleachers (gym) (Auditorium only $92.00 fee per use) Auditorium Seating (Commons) Do you wish to have a Technician on duty for EHS Little Theater use? Yes No

IF WEEKLY, LIST DATES:		END TIME: