APPLICATION FOR USE OF COLLEGE DISTRICT PROPERTY
The
Name of Organization
Address
Number and Street City State Zip Code
Contact Represented by
Business/ Cell E-mail Address Preferred Method
of Contact
Officer / Agent Name
Hereby applies for a permit to use
District Property
for the purpose of
for the below-listed dates and times: Admission will be charged Yes No
Hours
Date Open Close Room/Field
Ot
her considerations:
Special services/equipment requested:
Comments: Applications must be submitted at least 60 days in advance. Hours applied for must include time needed to setup and breakdown. Property
may only be us
ed during authorized permitted times. All properties are to be left in the condition in which they were found. Absolutely NO FOOD or DRINK
is permitted inside property. Entry foyer area may not be used for any sales or admissions transactions. The District reserves the right to charge for
parking and/or rent parking lost to user groups. Additional fees will be charged for any damage to campus property and if occupied outside of times
approved on the agreement. No flyers or signs for the event are to be posted on community streets.
I, The undersigned, state that the property for which application for use is herein made will not be used for the commission of any act prohibited by law. Further I and the
organization named herein agree to hold harmless the District, its employees/officials, from ALL claims for damages or injuries arising from use of any property granted under this
application; to fulfill the conditions and to observe the rules listed below.
1. Royalty payments under U.S. copyright law shall be paid by the permittee.
2. No activity shall be allowed which degrades the race, religion, nationality, color, sex, age, or disability of any person.
3. No smoking shall be permitted, except as otherwise posted.
4. No selling or vending of any article shall be permitted, unless specifically approved by the District.
5. No food or confections may be served in any auditoriums.
6. No alcoholic beverages may be on District property at any time, except in connection with a course of instruction sponsored by the District.
7. No furniture or equipment may be moved, except under District supervision.
8. The permittee is responsible for the care and protection of the property in their charge.
9. No religious doctrine may be taught or practiced except as specified in the permit.
10. Permittee shall provide a certificate of liability insurance, naming the District as an additional insured, in an amount established by the District, evidencing coverage for injury to
persons or damage to property which may arise out of the premittee’s use of District property. For all athletic activities, such insurance shall be in an amount not less than
$2,000,000.00
I certify or declare under the penalty of perjury that the foregoing is true and correct.
Signature
Date
FOR CAMPUS COORDINATION: DISTRIBUTION:
Original to campus office: Business Office
Copy for your file
Master Calendar
Student Affairs Plant Supervisor
Miramar
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signature
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