Auditorium Form – West Branch Area School District

Person in Charge of event: *

First

Last

Email *

Phone Number *

Event Name

Organization in Charge of Event: *

Type Of Organization:

School Affiliated
Non School Affiliated

Area(s) Needed:

Seating Area Only
Stage Area Only
Stage and Seating Area

Date(s) of Event(s): *

Time(s) of Event(s): *

Is this request for multiple dates? *

Yes
No

List other dates:

Please check all that may apply: *

(If you select NONE, you will only have the house lights and dim stage lights.)

Additional Needs:

Keys or building access for long term auditorium use
Crew to run Sound and Light Boards
Access to Rigging Ropes (for Light bars, hanging stage banners etc.)
Advanced Productions and Technical Needs (Drama, Concerts, Other)

Will Security be Needed? *

Yes
No

Sign Here *

By “Signing” above you hereby agree to abide by all rules and regulations and make such payments as approved by the Board of School Directors governing the use of said facilities and equipment. Furthermore, you… 1.) agree to exercise discretion regarding the use of said facilities and equipment, to make all necessary arrangements for the services of approved personnel, to assume responsibility for damage of school property and equipment, to use only those facilities and areas as stated above, and to assume all responsibility for the actions and conduct of the participants. 2.)agree to hold the school district harmless from all claims for injury to or the death of any person and for damage to or loss of any property arising out of or attributed directly or indirectly to the operations or omissions of the school district. 3.)indemnifies the school district for all damage to property belonging to the school district and for all injuries to the deaths of any representatives or employees of the school district resulting from all acts or omissions or use. 4.)acknowledge that the school district is not responsible for user’s property. 5.)agree that user must arrange all protective services desired by user. 6.)agree that the school district is not liable for the acts or omissions of any protective services engaged by user. 7.)understand that the school district may cancel any scheduled events on short notice for district use. (Games, repairs, etc.) 8.)MUST INCLUDE A COPY OF YOUR LIABILITY INSURANCE FOR YOUR ORGANIZATION IF APPLICABLE. Please sign below indicating that you have read and agree to the policy.