Grass Lake School District 36
26177 W. Grass Lake Rd.
Antioch, IL 60002
The building and grounds of the Grass Lake School District shall be made available for all worthwhile community activities which do not interfere with the regular school program(s) or which are sponsored by not-for-profit organizations.
Requests for building use must be accompanied by this application. Additionally, if a custodian is required, the hourly cost of the custodian must be paid by the organization requesting the use of the building. Also, the Board of Education reserves the right to require a certificate of insurance from the group utilizing the facilities.
Name of Organization Making Request Today’s Date
Name of Person(s) in charge of activity
Area of the Building and/or Grounds Requested
Additional Equipment Requested
Date(s) Requested (please list month, day and day of the week (i.e., Thurs, July 7):
Hours Requested (please indicate AM or PM):__________________________________
The undersigned agrees that he/she will be responsible to the Board of Education for use and care of the Grass Lake School property. He/she further agrees that the custodian cannot permit the use of the facility except upon presentation of an official permit granted by the Superintendent.
Address City State Zip
Home Phone Work Phone Cell Phone
Approval of Superintendent Date
Updated Grass Lake School Gym Rules
1) With the exception of water, absolutely no food or drinks are allowed inside the gymnasium. Please eat/drink in the concessions hallway only.
2) During rain or winter, organizations are required to wipe off their feet before walking on the gym floor. Water on the gym floor could cause the wood to warp. Additionally, if water is spilled or brought onto the gym floor, please wipe or mop up the water.
3) Hard baseballs or similar hardened sports equipment are not allowed. Baseballs (and similar balls) will cause divots into the wood.
4) To avoid wear on the center circle, all activities requiring a center-court face-off must be done outside of the center circle.
5) Cleats are not allowed on the gym floor. If participating in athletic activities, proper gym shoes are required.
I have read the additional rules and understand our group is responsible to the Board of Education and Grass Lake School for use and care of the Grass Lake School property.
Name of Person Requesting Usage
Grass Lake School District #36 Facility Usage Addendum
1. Your group may only access the following areas (please note, the security system is armed during the evening with the remainder of the building):
2. Maintenance staff will be the liaison for the district (6:30a.m. to 2:30p.m.). The district liaison will conduct a walkthrough at the beginning and ending of the visit.
The district will supply the following:
üGarbage bags and garbage cans for both inside and outside use.
üUse of the kitchen cookware.
üMonitors, keyboards, and mice are available if you would like to bring a computer (laptop, desktop tower, etc.).
üAn instructor’s station will be created for each classroom.
üA television/VCR/DVD is placed in each classroom for use.
üRecreation equipment by request.
üOther items that may be needed should also be requested.*
*If an item is needed that could be supplied by the district, the organization will make a request to the liaison.
3. Classrooms are designated as instructional areas only. Sleeping, recreational activities, cooking, laundry, hygiene, etc. must be done in either the multipurpose room or the gymnasium.
4. Organization is responsible for bringing own supplies. Do not use teachers’ or schools’ supplies.
5. Only use dry-erase markers on whiteboard.
6. Teacher’s desks may not be used. Please only use the instructor’s station.
7. Teacher’s desk drawers, filing cabinets, lockers, or other school related areas within the classroom may not be entered.
8. Organization may only tape items onto the erasable whiteboard. Do not tape onto lockers, walls, or bulletin boards.
9. School computers are not available for use.
10. Food or drinks are not allowed in the classrooms or gymnasium. Please keep all food limited to the kitchen and cafeteria.
11. The kitchen and cookware must be cleaned if used.
12. Laundry lines must be done in the multipurpose room or gymnasium. Laundry lines are not allowed in the classrooms.
13. Do not adjust the air conditioning unit. If adjustment is needed, please see the district liaison.
14. No modifying district property without consent from the district liaison.
15. Due to Illinois State law, the locker room showers are not available for use by any organization, including Grass Lake School.
16. All stakes must be removed from the grounds.
17. All garbage created by the organization must be picked up both inside and outside the school.
18. In the event of heavy rain, vehicles cannot be parked on grass.
A deposit of $200 may be required. The deposit will be returned after the exiting walkthrough.
If the terms of the agreement are violated, the organization must vacate the campus.
District Representative Printed Organization Representative Printed
District Representative Signed District Representative Signed