Request for Use of School Facilities

Application Date : * +

School Year: *

Organization Name : *

Is this a school sponsored event? *

Yes

No

Facilities / Needs

School to be used : *

Facilities to be used : *

Auditorium	Cafeteria	Classroom (s)
Field house	Food services required	Gymnasium
Kitchen	Lecture Hall	Library
Other Other

Classroom(s) to be used:

Equipment needs : *

Audio Visual	Sound system	Electrical
Scoreboards	None	Other Other

Other equipment needs : (Tables, Chairs, Setup, Etc.)

Event Info

Expected Attendance : *

Admission Charged : *

Yes

No

Fee : *

Event date(s) * 🛈 +

+

Event start time : *

Event end time : *

Event prep start time : (Building open) *

Other Details:

Coordinator Info

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Phone Ext.

Additional Phone Number

Email Address *

I have recieved a copy of the Rules and Regulations for the use of Wakefield Public Schools Facilities and I agree to all applicable conditions and Fees.

Lessee agrees to provide "Certificate of Insurance" with the Town of Wakefield named as an additional Insured.

I have read and agreed to the above statements : *

Yes

No

Digital signature of applicant : *