RELEASE OF LIABILITY, INDEMNIFICATION AND HOLD HARMLESS AGREEMENT

Transcription

1 2540 East County Road F White Bear Lake, MN Exhibit A RELEASE OF LIABILITY, INDEMNIFICATION AND HOLD HARMLESS AGREEMENT (name of participant) will not seek to have the School District held liable in the event that any accident, injury, or any other circumstance or incident occurs during or as a result of his/her use of the gymnasium or the school premises. This release of liability and indemnification includes accidental injury, loss, or damages to the undersigned participant, as well as to other individuals or property that may result, directly or indirectly, from the undersigned participant s willful or negligent conduct. (name of participant) hereby releases and agrees to hold harmless and indemnify the School District, their officials, agents and employees, from and against any claims arising out of his/her use of the gymnasium or school premises in accordance with this Agreement. The undersigned has read and understands and accepts all of the statements recited above and accepts full responsibility as described. Participant s Signature Northeast Metropolitan Intermediate School District 916 9/12

2 CAPITOL VIEW CENTER ROOM RESERVATION REQUEST Event Title: Contact: Work Phone: Today s : Address/Site: City: State: Zip Code: MEETING DATE/S: TIME ROOM IS NEEDED: AM PM to AM PM ACTUAL MEETING TIME: AM PM to AM PM # OF PEOPLE: ROOM REQUESTED: Board Room (Seating: 20; Capacity: 43) Capitol Room (Seating: 100; Indicate Set-up) Room 200 Auditorium (150 Fixed) ROOM SET-UP: Room 303 (Tiered Seating; Capacity: 32) Gymnasium EQUIPMENT/TECHNOLOGY REQUESTS: Herringbone Easel/Flip Chart Computers on Wheels (12 laptops) Hollow Square Webcam ipads (STAFF ONLY) (6 ipads) Rows/Classroom Style Microphone/Speakers Laptop U Shape Document Camera LCD Projector Presentation Table Printer SMART Board Other Conference Phone Other Computer Speakers No Equipment Needed SPECIAL ACCOMMODATIONS: **Please make sure the room is clean before you leave. Cleaning supplies are located in each room. Thank you** CONFIRMATION (Please leave blank) ROOM ASSIGNED: Board Room Room 200 Room 303 Capitol Room Auditorium Gymnasium Assigned By: 4.13 :

3 2540 County Road F East White Bear Lake, MN LEASE AGREEMENT Northeast Metropolitan Intermediate School District No. 916 ( School District ) hereby Agrees to lease to the ( Lessee ) the Capitol View Center Gymnasium located at 70 West County Road B2, Little Canada, Minnesota, in accordance with the following terms: Purpose of use (specify events or activities, practices or games, sport, and identify team name, if one exists) Duration of use (specify months or season and year) Frequency of use (specify number of days per week and which days per week) Hourly rate In consideration for the use of the gymnasium or other school space as stated above, the undersigned Lessee shall pay the hourly rate noted above to be billed after usage at the end of the month. Each individual participating in the use of the school premises under this Agreement shall enter into a Release of Liability and Hold Harmless Agreement, attached as Exhibit A. Signature of Lessee Street Address City, State, Zip Telephone number of Lessee Northeast Metropolitan Intermediate School District 916

4 CAPITOL VIEW CENTER 70 West County Road B-2 Little Canada, MN ROOM RENTAL RATES ROOM CAPACITY FULL DAY RATE EVENING OR ½ DAY RATE Board Room 20, Fixed Square $ $95.00 Room , Square 35, Theater $ $75.00 Room Tiered Seating $ $75.00 Capitol Room 300 Capacity (tables & chairs for 80 are available) $ $ Large Gym Saturday $ $45 per hour (2 hour minimum) Available weekdays after 5:00 p.m. Small Gym Saturday $ $25 per hour (2 hour minimum) Available weekdays after 5:00 p.m. Auditorium 150 Fixed Seating $ $ Add an additional $60 per hour maintenance fee on Saturdays. Minimum charge of 2 hours. 2. Add an additional $55 per hour maintenance fee after regularly scheduled maintenance hours. Regularly scheduled hours are 7:30 a.m. to 9:30 p.m. weekdays. 3. All rates include use of screen and LCD projector only. Jayne Palony, Office Assistant Capitol View Center September (voice) (fax) jayne.palony@nemetro.k12.mn.us Revised: 9/25/14

5 Valley Crossing Community School An adventure in interactive learning Facility Reservation and Permit Form Name Group/Organization Reason Address Phone Fax (s) Time: to Room(s) Needed Number of People Additional Comments: Charges - Room Use $ Custodial $ Total $ Room Full Day 1/2 Day or Less & Evenings 1 hour Classroom $125 $75 $40 Gymnasium $300 $180 $90 Cafeteria/Media $250 $150 $75 Cafeteria is available on weekends only. Kitchen Fee is $35.00 an hour available by special request. Custodial Fee is $50.00 an hour for evenings after 6p.m. and $70.00 an hour all day on weekends. There will be a $5.00 per hour fee for groups using the building prior to 6:00 p.m. on weekdays. This signed form is your authorization and permit for entry and use of the specified facility. Equipment is not available. You will need to furnish your own (projectors, computers etc.) and also your own supplies. Also, because our custodial staff is short-handed it is necessary for users of our building to do their own setting up of chairs, tables and equipment. All organizations, groups, and individuals shall furnish a certificate of liability insurance. In addition to the charges indicated above, you agree to abide by all the appropriate Federal and State laws and regulations of the District governing the use of these facilities and equipment. Please sign and return this form, Hold Harmless Agreement & Certificate of Liability Insurance to Valley Crossing, 9900 Park Crossing, Woodbury, MN Phone number: Fax number is The charges above are approximate. You will receive an invoice from District 916. Please refer any billing questions to Chris Zschau, Signed Signed Organization or group Principal-Valley Crossing

6 Valley Crossing Community School An adventure in interactive learning NOTICE TO USERS OF SCHOOL FACILITIES 1. Only authorized users of school facilities may be in the building. No loitering. 2. The supervisor of the scheduled activity is responsible for the actions of all persons in their activity. Keep all participants or guests of your activity in the area assigned and under supervision. 3. The supervisor of the activity must be the first person in the building and the last to leave. Please keep your activity to the area that has been designated for your use. 4. Be respectful of all school property and other persons in the building. Any damage suffered as a result of your use will be assessed against you or your group. 5. Classroom supplies are property of the school staff and the students who attend this school, this includes markers, crayons, pencils, glue, scissors...etc. If you are using space in the Neighborhoods, you will need to furnish your own supplies. 6. Obey all fire alarms and evacuate through the nearest safe exit. 7. Do not remove furniture and equipment from any area without permission from custodian or building supervisor. 8. Some classrooms have small animals, please do not remove animals from their cages. 9. Please minimize your demands on the custodians time. Return all furniture to its original place and turn off all lights before leaving. 10. Children must be supervised by an adult at all times. Thank you!!!

7 LEASE AGREEMENT RELEASE OF LIABILITY AND HOLD HARMLESS AGREEMENT Northeast Metropolitan Intermediate School District No. 916 ( School District ) hereby agrees to lease to space at Valley Crossing Community School located at 9900 Park Crossing, Woodbury, Minnesota, in accordance with the following terms: Specific rooms to be used Purpose of use (specify event or activity, practices or games, sport, and identify team name) Duration of use (specify months or season and year) Frequency of use (specify number of days per week and which days per week) _$ Hourly rate In consideration for the use of Valley Crossing Community School as stated above, shall pay the hourly rate noted above and shall agree to the following Release of Liability and Hold Harmless Agreement. will not seek to have the School District held liable in the event that any accident, injury, or any other circumstance or incident occurs during or as a result of the use of the gymnasium or the school premises. This release of liability includes accident, injury, loss, or damages to the event or activity participants, players and coaches, as well as, to other individuals or property that may result from participation in or attendance at an event at Valley Crossing Community School. hereby releases and agrees to hold harmless the School District, their officials, agents and employees, from any claims arising out of the use of the gymnasium or school premises in accordance with this Agreement. The undersigned has read and understands and accepts all of the statements recited above and accepts full responsibility as described. The undersigned has the authority to enter into this Agreement on behalf of the event or activity participants, players and coaches involved in this activity. Authorized Signature on behalf of Lessee : Title of Individual Authorized to sign this Agreement Valley Crossing Community School, Lessor : Revised: 9/26/14