NEPN/NSBA Code:  KF-E2

LEWISTON PUBLIC SCHOOLS

FACILITIES RENTAL AGREEMENT

Name:_________________________________________________________________________________________

(Enter name of group or organization making request.)

Responsible

Person: _____________________________________________________________ Telephone: ______________________________________

Print Name

Address:

Requests the use of: (Check facility desired. Rates are per day.)

Auditorium * Gymnasium

Classroom (if available) Locker Room(s)

Cafeteria w/Kitchen *** Cafeteria w/out Kitchen

1⁄2 Cafeteria w/Kitchen (where avail)*** 1⁄2 Cafeteria w/out Kitchen. (where available)

Band Room/Music Room ** Other:

Multi-Purpose/Lecture Hall

The auditorium rental fee is payable at the time the signed contract is returned to Lewiston Middle School.

Date: Program Hours: 

Set-Up Hours: 

For:_____________________________________________________________________________________________

(Purpose of use to be indicated specifically)

Approximate number to be accommodated:

Is an admission fee to be charged? _____________Yes  _________No

For what purpose are funds to be used?

* Rental fee does not include theatrical lighting or sound system. Renter will announce “No food or beverages allowed.” First rehearsal for any production is free and additional rehearsals will be 1⁄2 the rental fee.

** Generally not available during school year.

***Any required kitchen fees to use cooking equipment apply to all groups in all classifications.

Rental Agreements should be returned to the Building Administrator’s Office as soon as possible to ensure date of facility requested. When a Sunday use is requested, the request shall be received at the Building Administrator’s Office at least one month prior to the date desired.

Organizational Classification_______________________________________________________________________________-

(Determined by school officials)

Basic Fee:_____________________________________________________________

  Make check payable to Lewiston Public Schools

_______Police officer required-When required, the police officer will be ordered to report for duty by the party renting the facility.

______If theatrical lighting or technology is required, an agent of Lewiston Public Schools must be employed at the rate of $30 per hour (amount subject to change). This includes setup, operation, and dismantling.

______When kitchen cooking equipment is required, an agent of Lewiston Public Schools must* be utilized at a fee of $30 per hour. This fee includes setup, operations, and cleanup of cooking equipment. No one under the age of 18 is allowed in a kitchen without adult supervision. (Rate subject to change.) * A volunteer who is qualified to utilize kitchen cooking equipment, as determined  by and requiring the approval of the Lewiston Nutrition Director, may be utilized in place of an agent of Lewiston Public Schools.

An additional charge may be required for supplementary facilities.

All organizations renting the facility have to provide evidence of Liability Insurance coverage in the form of a certificate of insurance prior to the date of the event.

NOTE: Custodial fees will be charged to all groups in all classifications. Rate: $30/hour (amount subject to change).

Safety Procedures: (Disregard will result in immediate termination of event or removal of person(s) from school grounds.)

1. Smoking, profanity and disorderly conduct under any and all circumstances are prohibited in any school building per Lewiston School Committee policy.

2. Ensure outside doors are closed and locked when leaving the building.

3. Ensure any windows that were opened are closed before leaving the room/building.

4. Turn off lights and equipment (media) when leaving.

5. Any keys given out for a room or building must remain with the person they are given to and not be given to others including students.

6. If using the building during days that school is in session, please check with the front office upon arrival.

7. When entering the room or area being used, please find and review emergency evacuation procedures.

8. Students are to be supervised at all times.

9. Police the area being used before and after an event to check for any hazards or damages and report it immediately to the building custodian.

10. Please inform the building custodian when you leave the building.

11.Insure that you are the last person to leave and that everyone has left the building. Be sure any students needing transportation have been picked up.

I hereby state that the information in this application is true and accurate and that, if approved, I will abide by the rules and regulations for the use of public school buildings as set by the Lewiston School Committee.

Signature: ____________________________________________________Date: ___________________________________

Print name:________________________________________________________

Approved:_______________________________________________________________________________ Date:_______________________________

(Building administrator)

________________________________________________________________________________ Date: ______________________________

(Superintendent/Facilities Director/Nutrition Director)

FULLY EXECUTED COPY TO THE BUSINESS OFFICE

Middle School telephone: (207) 795-4180................School fax: (207) 753-1789

High School telephone: (207) 795-4190....................... School fax: (207) 795-4119

5/03, 7/08, 6/09,

9/12, 7/13, 7/15, 1/17