Garfield Re-2 Policies

KF-E 2

Facility/Site Use Checklist

Organization/Individual Information

Name of Organization__________________________________________________________________________

Mailing address_______________________________________________________________________________

                         _______________________________________________________________________________

Name of sponsor______________________________________________________________________

Sponsor’s work phone (      )___________________________ Cell phone(s)_______________________

Sponsor’s home phone (     )___________________________ e-mail_____________________________

Facility/Site information

Building being used___________________________________________________________________________

Room(s) being used__________________________________________________________________________

Reason for use______________________________________________________________________________

Date(s) requested____________________________________________________________________________

Time requested From______________________________ to _____________________________________

Number of participants_______________________________

Equipment Information

Equipment needed ___________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Conditions prior to use:  (Y or N)

 

_____1.  trash cans emptied _____2.  lights working _____3.  floors swept

_____4.  walls damaged _____5.  damaged furniture _____6.  area generally clean

_____7.  door locked _____8.  bathrooms clean/stocked _____9.  bathroom damage

_____10. ceiling tiles _____11. keys returned if required   _____12. other items to note

Condition comments by number:

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Signatures

Organization Sponsor ______________________________________ Date___________

Attendant________________________________________________ Date___________

 

Issued:     September 25, 2007      

Reviewed:  April 23, 2019

 

Garfield School District No. Re-2, Rifle, Colorado