Revised Sept. 2019								Date_________________
Rental fees - rates are subject to change without notice
									
			Name of Event ______________________________________
_______________________		____________________________	_______________________	 Building				    	Facility Required		    		Organization

____________________		      ____	     ____	    ________        _______	  _______      _______________________	
Date	(MM/DD/YY)	 Reoccurring Yes	      No	   day of week      Time in	  Time out     Time in (for setup if needed)
						   (if yes)			      
_____________________________	_______________________________	__________________________
Contact					E-mail address				Phone

_______________________________________________	__________________________________________________
Address							 City/State/Zip

____________________________________________________	___________________________________________
Representative of School Related Organization / Group		Representative, Sylvania Board of Education

*School Related Groups include: Parent Organizations, Athletic Booster Organizations, Band, Orchestra & Choir boosters, Academic Boosters, S.C.A.T., Sylvania Community Services (SCS) & Sylvania Area Joint Recreation District. These Groups WILL NOT be charged a Building Usage Fee but MAY need to pay to cover Custodial, Food Service, or other employee overtime costs.  Note that S.C.S. & S.A.J.R.D. WILL need to sign a waiver of Liability and submit a certificate of insurance.  Signing this form also acknowledges compliance with all terms and conditions of the “Rules Governing the Use of School Property”.
_____________________________________________________________________________________________	__________
(For official use)
School Related Groups will never be required to pay any custodial labor cost for use of a building during the regularly scheduled school day OR the evening of a regularly scheduled school day (assuming that their use of the facility is completed prior to the end of the custodians regularly scheduled shift).  School Related Groups MAY be required to pay for custodial labor IF their use of the facility involves serving food and/or involves a very large number of participants.  This will be at the discretion of the Building Administrator, the Director of Operations and/or the Superintendent (or his/her designee).  If the group will be required to pay for any labor charges they will be based on the following rates:
Custodial Hours (minimum 4 hours)			Food Service Staff (Minimum 4 Hrs.)*		
Mon. – Fri.   ____Hrs. @ $29.00/Hr. - $______		Mon. – Fri.  	 Hrs. @ $26.00 /Hr. -  $_____            
Evening/Sat. ____Hrs. @ $44.00/Hr. - $______		Evening/Sat.	 Hrs. @ $39.00 /Hr. -  $_____    
Sun.	       ____Hrs. @ $58.00/Hr. - $______		Sun.	               Hrs. @ $52.00 /Hr.  - $_____     

Audio / Visual for either Performing Arts Center’s	
Services Needed District Technicians (minimum 4 hours) 									Lights  ______	Sound  _______ 					
Technician:						
Mon. – Fri.     ____Hrs. @ $32.00 /Hr.-$________		Other Needs such as tables, chairs etc. (please specify)		
Evenings/Sat. ____Hrs. @ $48.00/ Hr.-$________									
Sun.	                 Hrs. @ $64.00/Hr.-$ ________														
*If Kitchen is to be used to prepare food then group must pay the cost of at least 1 District Food service employee.	
							
Athletic Grounds Crew (minimum 4 hours, If Outside Athletic Facilities at High Schools are used)
Mon .- Fri.   ____ Hrs. @ $35.00/Hr. -   $______
Evening/Sat.____ Hrs. @ $55.00/Hr. -   $______
Sun.	      ____ Hrs. @ $70.00/Hr. -   $______

Student Workers 

______ Hrs. @ $10.00/Hr.	-   $ _______			Total 				$_________________

Note that for the labor hours listed (on the previous page): 
Mon. – Fri. indicates labor charges for the time during a NORMAL workday for District employees.  Evening/Sat. rate will be charged for any time beyond the normal workday EXCEPT Sunday which has a separate rate listed.  

Custodial staff will be paid ½ hour minimum for set up, for the entire event and for a minimum of ½ Hr. to clean up and lock up after the event.  The number of custodians required to clean up the facility after event will be determined by several factors including (but not limited to) the number of people attending the event and if concessions are sold (or food served) at the event.  In this case, the lessee will be charged a minimum of 4 Hrs. for the number of custodians required for cleanup of facility.  

The above fees will be used to calculate the fees for labor to cover an opening of the facilities designated above.  The application of these fees is at the sole discretion of the District.  In addition to these fees and submitting this completed form, the group MAY also be required to submit a signed waiver of liability and supply the appropriate certificate of Liability insurance.  These forms along with the “Rules Governing Use of School Facilities” can be found on the District website at www.sylvaniaschools.org

Copies to:    1. Applicant   2. Audio Visual	  3. Treasurer   4. Building Office   5. Building Custodian    6. Athletic Grounds

Insurance			Received  ______	On File  ______

Hold Harmless		Received _______	On File  ______