MT. SAN JACINTO COMMUNITY COLLEGE DISTRICT
Maintenance and Operations Department
APPLICATION FOR USE OF DISTRICT FACILITIES
REQUESTING ORGANIZATION DETAILS:
Organization Name: Date:
Is the organization a registered 501(c)3 nonprofit entity? Yes No If yes, tax ID:
Requestor Name/Title: Phone #: ( )
E-Mail Address:
Mailing Address:
Street Address City/State/Zip Code
EVENT DETAILS:
Campus Location: San Jacinto
Facility/Room(s) Requested:
Is event open to the public? Yes No
Menifee Banning Temecula Education Complex
Will restrooms be needed? Yes No
# of expected attendees:
Will admission be charged or a donation requested to attend? Yes No
Event Description:
Special equipment/ setup requested:
NOTE: For Theatre use, please contact Jeffrey George at JGeorge@msjc.edu no less than forty five (45) days prior to
the submittal of the application.. DISTRICT EMPLOYEES MUST SUBMIT WORK ORDER REQUESTS FOR SET UP NEEDS!
Day Date of Event Setup Time Start Time End Time Breakdown Time
Monday
AM / PM AM / PM AM / PM AM / PM
Tuesday
AM / PM AM / PM AM / PM AM / PM
Wednesday
AM / PM AM / PM AM / PM AM / PM
Thursday
AM / PM AM / PM AM / PM AM / PM
Friday
AM / PM AM / PM AM / PM AM / PM
Saturday
AM / PM AM / PM AM / PM AM / PM
Sunday
AM / PM AM / PM AM / PM AM / PM
Indemnification and Hold Harmless. The Requesting Organization utilizing District facilities will indemnify and hold harmless Mt.
San Jacinto Community College District and its Board of Trustees, officers, directors, employees, representatives, agents, and
volunteers from and against any and all claims, actions, causes of action, demands or liabilities of whatsoever kind and
nature, including judgements, interest, reasonable attorney fees, and all other costs, fees, expenses, and charges
(collectively, “Claims”) to the extent that such Claims arise out of or were caused by the negligence, gross negligence or the
willful misconduct of the indemnifying Party or from any breach of the Agreement by the indemnifying Party.
The undersigned hereby confirms their understanding that total fees due and the Certificate of Insurance listing the District
as an additional insured must be received by the District at least five (5) working days prior to the use of facilities. The
undersigned also agrees to abide by the procedures and regulations of the District noted on pages 2-3 of this document
relating to the use of facilities.
Printed Name: Signature:
Title: Date:
Send the completed/signed form via e-mail to: FacilitiesDepartment@msjc.edu
Questions? Please contact the M&O Department: 951-487-3105 (San Jacinto Campus) or 951-639-5108 (Menifee Campus)
Page | 1
PROCEDURES AND REGULATIONS/RESTRICTIONS FOR USE OF MSJC DISTRICT FACILITIES
PROCEDURES:
Each Requestor wishing to use college facilities must submit a completed Application for Use of District
Facilities and adhere to the following:
1) An authorized administrator of the organization requesting facilities must sign the application.
2) Each requesting organization shall designate a contact person to be responsible for any theft or damage
to equipment and/or facilities. The same person will also be responsible for providing the certificate of
insurance listing the District as an additional insured, confirming setup and equipment requirements and
initiating rental fee payment.
3) The Application must be submitted to the Maintenance & Operations Office no less than 45 days prior to
the requested event date. For Theatre requests, please contact Jeffrey George at JGeorge@msjc.edu no
less than 45 days prior to requested event date. E-mail to send form is: FacilitiesDepartment@msjc.edu.
4) By signing the application, the authorized administrator of the requesting organization affirms their
understanding the regulations stated below.
5) At least five (5) working days prior to the event the following must be received:
A certificate of insurance with combined single limit liability policy of $1,000,000
* in which Mt. San
Jacinto Community College District is listed as additional insured (may not be required for a MSJC
sponsored event), and;
Full payment for the use of facilities.
*NOTE: For athletic events and certain other events, the District has the right to require a higher insurance
amount at the District’s discretion.
6) The event will be cancelled by the District if payment and/or insurance documentation is not received
five (5) working days prior to the event with no refund to be provided.
7) At the District’s discretion, a security deposit may be required. Any damage to District equipment or
facilities would be deducted from the deposit, with the remainder returned. If there are no damages, the
deposit will be returned in full.
REGULATIONS/RESTRICTIONS:
1) No group or organization may use District property for purposes that discriminate on the basis of race,
color, religion, ancestry, national origin, disability, gender identity, gender expression, or sexual orientation,
or the perception that a person has one or more of the foregoing characteristics or because a person
associates with a person or group with one or more of these actual or perceived characteristics or on any
basis prohibited by law.
2) The requesting organization is responsible for the conduct its participants while they are on MSJC premises.
All MSJC rules and regulations must be adhered to.
3) MSJC officials have the right to terminate the use of District facilities immediately and without notice upon
its discovery of a violation of any term, condition or provision of this policy.
4) The requesting organization is required to furnish such supervision and law officers as the MSJC
administration determines is necessary for the protection of individuals, property and to the enforcement of
these regulations.
5) The event is not to interfere in any manner with the normal activities of the college.
Mt. San Jacinto College District Application for Use of District Facilities Page | 2
6) Parking is restricted to the following parking lots: San Jacinto Campus lots B, C & D; Menifee Campus lots A,
B, C & D at the cost of $2.00 per day, per vehicle. No vehicles are to enter upon or drive on any part of the
campus without expressed written permission of the college district.
7) MSJC has a strict no smoking policy.
8) MSJC does not allow animals on campus, with the exception of qualified service animals per California
Penal Code Section 365.5, subsections (a), (b), (c), and (d).
9) No alcoholic beverage may be brought onto or consumed on any MSJC campus.
10) Requesting organization’s participants are restricted to such facilities as permission for use has been
granted, including restrooms.
11) Requesting organization’s participants are required to conform to any requests or directions given by district
Campus Safety Officer (CSO), Custodian, Grounds Keeper or Technician in charge, regarding the use and
proper care of all MSJC property.
12) MSJC must approve any decorations, props, equipment or other devices brought onto the premises. A fire
retardant certificate may be required for decorations. No decorations may be attached to buildings or
equipment without prior approval and supervision of a District representative.
13) The requesting organization is responsible for the removal and proper disposal of all decorations, props,
equipment or other devices used in connection with an event immediately after the event. A minimum
fee of $200 or the actual clean-up cost will be charged to the organization should District personnel need
to clean, whichever is higher.
14) Requesting organization is responsible for return of facilities to the same conditions as they were at the time
of entry except for normal sweeping and final disposal oftrash.
15) All food service and use of the student center cafeteria shall be arranged with the MSJC Director of Food
Services.
16) Requesting organization is responsible for and shall be liable for any damage to college property or
equipment, including repairs or replacement made necessary by the negligence of or misuse of the
Requestor.
17) No activity shall be conducted which constitutes a violation of any federal, state, or local law.
18) For further information on the District’s use of facilities policies, please refer to the MSJC website at:
http://www.MSJC.edu.
The above procedures and regulations/restrictions for facility use have been read and agreed to by:
Printed Name: Signature:
Title: Date:
Mt. San Jacinto College District Application for Use of District Facilities Page | 3
DISTRICT USE ONLY BELOW THIS LINE:
SUMMARY OF CHARGES:
# of hours # of days Room # Facility/Building
Current Rate Total Amount
$
$
$
$
$
$
$
$
Other Charges:
$
$
APPROVALS:
MAINTENANCE & OPERATIONS
OFFICE OF INSTRUCTION
Date:
Date:
VICE PRESIDENT, BUSINESS SERVICES
Date:
Distribution List:
Instruction
Maintenance
Risk Management
Campus Safety
Public Information
Mt. San Jacinto College District Application for Use of District Facilities Page | 4
MT. SAN JACINTO COMMUNITY COLLEGE DISTRICT
SCHEDULE OF FEES FOR USE OF DISTRICT FACILITIES
Facility Type: Non Profit Cost Commercial Cost
Classroom—Seating up to 40 $ 45.00 per hour $ 70.00 per hour
Classroom—Seating over 45 $ 55.00per hour $ 75.00 per hour
Computer Classroom—Max Seating 30 $ 60.00per hour $ 90.00 per hour
Cafeteria/Dining Room $ 100.00 per hour $ 200.00 per hour
Large Lecture/Auditorium—Seats over 45 $ 100.00 per hour $ 200.00 per hour
Theatre—Seating up to 300 $ 150.00 per hour $ 225.00 per hour
Library $ 100.00 per hour $ 100.00 per hour
Shower/Locker Room—Per side $ 100.00 per day $ 150.00 per day
Conference Room—Max Seating 30 $ 40.00per hour $ 60.00 per hour
Conference Room—Seating over 45 $ 60.00 per hour $ 80.00 per hour
Gymnasium—Max Seating 776
$ 100.00 per hour $ 150.00 per hour
Football Field/Track
$ 100.00 per hour $ 150.00 per hour
Soccer Field $ 100.00 per hour $ 150.00 per hour
Baseball Field $ 100.00 per hour $ 150.00 per hour
Tennis Courts (per court) $ 50.00 per hour $ 75.00 per hour
Parking Lot $ 100.00 per hour $ 150.00 per hour
Offices* *Negotiated with District Business Services staff.
Additional charges (as required):
Custodial fees: Custodian(s) are required to be present for all events $ 60.00 per hour/staff
Audio Visual Fees: An audiovisual technician is required to be
present when sounds system or special lighting is required.
$ 60.00 per hour/tech
Grounds Keeper: The District, depending upon the event, may
require grounds keeper (s).
$ 40.00 per hour/staff
Computer Technician: A computer technician is required to be
present when computer equipment is required.
$ 60.00 per hour/tech
Campus Safety Officer(s)(CSO):May be required for certain events
at the District’s discretion.
$ 60.00 per hour/CSO
Mt. San Jacinto College District Application for Use of District Facilities Page | 5
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome