• 406-630-1523
  • Mon - Thurs 8a-4p | PO Box 458, Ekalaka, MT 59324

Facility Use Form

The below is copied from Policy 4330F.

School Facilities or Grounds Use and Liability Release Agreement

Ekalaka School District

Organization or Individual Requesting Facility Use: __________________________________________

Facility Requested: ____________________________________________________________________

Date and Hours of Requested Use: ________________________________________________________

Purpose of Use: _______________________________________________________________________

Will there be an admission fee? ______ If so, how much? _______________________________

Premises and Conditions

Conditions of Facilities Use - Use of District facilities is conditioned upon the following covenants:

1.  That no alcoholic beverages, tobacco, nicotine products, or other drugs are sold or consumed on the premises by the requesting organization or individual or any of its employees, patrons, agents, or members.

2.  That no illegal games of chance or lotteries will be permitted.

3.  That no functional alteration of the premises or functional changes in the use of such premises shall be made without specific written consent of the District.

4.  That adequate supervision is provided by the requesting organization or individual to ensure proper care and use of District facilities.

5.  The presence of weapons, including firearms, must be previously reviewed and approved by the Board of Trustees in accordance with Montana law.

Rent and Deposit

  The requesting organization or individual agrees to pay the District, as rent for the premises and as payment for special services (if any) provided by the District, the sum of $______________________, and this shall be due ______________ days in advance. The requesting organization or individual shall be responsible for the actual cost of repair or replacement, including costs, disbursements, and expenses, resulting while it has use of the premises.

Indemnification

  The requesting organization or individual, by signature below, hereby guarantees that the organization shall indemnify, defend, and hold harmless the District and any of its employees or agents, from any liability, expenses, costs (including attorney’s fees), damages, and/or losses arising out of injury or death to any person or persons or damage to any property of any kind in connection with the organization or individual’s use of the District facility, which are not the result of fraud, willful injury to a person or property, or willful or negligent violation of a law on the part of the School District. The undersigned organization or individual accepts and assumes all such risks and hazards and does hereby release the School District from any and all liability including, but not limited to bodily injury, personal injury, and/or property damage which are not the result of fraud committed, willful injury to a person or property, or willful or negligent violation of a law on the part of the School District.

 

Insurance

The user of the facility shall provide the District with a certificate of insurance and endorsement to their property and liability policy. Said certificate and policy endorsement shall name the District as an additional insured. The certificate and policy shall show coverage for comprehensive general liability insurance for injuries to or death of any person or damage to or loss of property arising out of or in any way resulting from the described use of the facility. The insurance shall provide for amounts not less than $1,000,000 for bodily injury or death to any one person or resulting from any one accident, and $1,000,000 for property damage in any one accident or the policy may provide a combined single limit for bodily injury and property damage for $1,000,000. The certificate shall contain a provision that the insurer not cancel or refuse to renew without giving the District written notice at least 10 days before the effective date of the cancellation or non-renewal.

 

 

Special Events Coverage

The district requires the event holder to purchase a special event liability policy for the event, and to name the district as an additional insured on the policy.  The event holder should provide the district with a certificate insurance outlining the coverage limits and that the district has been named as an additional insured on the policy.  Minimum coverage limits of $1,000,0000 per occurrence and $2,000,000 aggregate should be purchased.   

Assumption of Risk

The requesting organization agrees to indemnify, release and hold harmless the District, inclusive of its employees, administration, board of trustees, and insurers form any and all civil liability involving any and all forms of injury except those that may arise as a result of willful, wanton or reckless conduct by the District or its agents adding unwarranted danger to participation in such event.

The requesting organization understands that the District will take all reasonable precautions to insure the risk of injury to individuals accessing the facilities or grounds is minimized. However, even though these precautions are taken there is still a chance of injury, and in rare instances even severe injury and death. The requesting organization understands the risks involved.

The School District DOES NOT provide medical insurance for any individuals who choose to access and use the facilities.

Non-Discrimination

The District will consider requests for use of district facilities for political purposes and activity in accordance with Montanan law. The requesting organization or individual agrees to abide by non-discrimination clauses as contained in the Montana Human Rights Act and the Governmental Code of Fair Practices.

District’s Rights

The District reserves the right to cancel this Agreement, when it is determined by the District that the facilities are needed for school purposes, the event will violate District policy, or if the conditions outlined in this agreement are not satisfied..

  DATED this _____ day of _______________, 20__.

__________School District:         Requesting Organization or Individual:

By ____________________________________    By ____________________________________

                   Address ________________________________

                   Phone _________________________________

Additional Obligations __________________________________________________________________

_____________________________________________________________________________________

  • 406-630-1523
  • Mon - Thurs 8a-4p | PO Box 458, Ekalaka, MT 59324