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Who
Applicant Information
  1.    Save my contact information on this Email for later forms
    HCPS email address may be used for Internal (HCPS) events only.
  2. First Name    Last Name
  3. Home    Business
    Cell    Fax
What
  2. Please describe activities:
  3. This event is a school-based wellness activity.
    (Applies to HCPS Internal events only)
  4. Is this a fundraiser for the using group?
  5. I have read and reviewed the HCPS Use of Public School Facilities Policies and Procedures

  6.       
  7. HCPS Resources, References and Agreements between HCPS and Harford County agencies click here.
Where
When
Additional Services
  1. Will food be served?
  2. Is custodial service (overtime) required?
    CUSTODIAL PRESENCE IN BUILDING IS REQUIRED. A CUSTODIAN IS PAID AT TIME AND A HALF THEIR RATE OR PAY plus employer's portion of FICA and Worker's Comp. AN INVOICE WILL BE SENT TO YOU AFTER EVENT, if applicable).
  3. Technical Support Staff required?
  4. Name:
    Email:
    Address:
Other Information
  1. Is an admission fee being charged for this event?
  2. Comments and any other special requirements

INSURANCE REQUIREMENT: In accordance with HCPS Use of Public School Facilities Procedure, Section IV, a current Certificate of Insurance reflecting HCPS as an additional insured must be on file in the Office of Operations prior to approval. Failure to provide this document will result in being taken off the school calendar.

I, the undersigned, certify the facility will be used exactly as described on this application and any alterations to that use must receive prior approval by the building Principal (or designee). I am authorized to sign this contract on behalf of the using group, have read and fully comprehend all fees, rules and regulations as contained in the Use of Facility Policy and Procedures associated with the community’s use of schools and agree to indemnify, save harmless and defend the County, the Board of Education, the individual members thereof, and any school or Community Use of Public Facilities officials or employees from any loss, cost, damage, claim or other expense suffered or incurred that may arise during or be caused in any way by such use or occupancy of school property, including any loss or injury of any kind alleged to be the result of any negligence by Harford County, the Harford County Board of Education, or any of its agents, employees or officials. In the event of Harford County Public Schools property loss is incurred as a result of the use of the facility, the amount of damage shall be decided by the Principal (or designee) and the Assistant Superintendent for Operations. The use and applicant shall be charged accordingly. I, also, understand and agree that I am personally responsible and liable for all fees/expenses incurred as a result of the use of the facility which is the subject of this application.

Entry of your email address constitutes your consent and agreement to the terms and conditions set forth above:

Administration Fee: $ 25
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