It is agreed by and between the North Mahaska School District and the organization and/or person noted below that the school district hereby rents to renter the following described premises for the times and fees recorded:
Facility: Auditorium Elem. Gymnasium H.S. Gymnasium
Elem. Kitchen Elem. Cafeteria Elem. Classroom
H.S. Kitchen H. S. Cafeteria H.S. Classroom
Purpose: ______________________________________________________
Date: ______________________ Hours: ___________________
Total Fee: _____________________
Rent for use of the facility shall be paid to Board Secretary within 5 business days after the date of rental. Payment for custodian and/or cook, if
applicable, shall be paid to the school. Hours for facility rental and employee pay shall be from time facility is unlocked until facility is locked and
building closed.
Please refer to the back of this agreement to determine the proper use of school facilities. The applicant is responsible for enforcing these regulations.
The applicant must provide an Indemnity and Liability Insurance Agreement,
Code No. 1004.1E2, prior to the use of facilities.
Name of organization making application: ________________________________
Name of person making application: ________________________________
Address: _______________________ Phone #: _________________________
_______________________________________________
(Signature of Applicant) (Date)
(Must be at least 21 years of age)
_______________________________________________
(Signature of Superintendent) (Date)
