Building Facilities Rental Form

Building Facilities Rental Application

Name:   (Enter Name of person or organization making request.)

Address:

Request the use of: (Enter name of building facility desired.)

Auditorium    Gymnasium   Cafeteria  Locker Room Shower   Classrooms  

Other 

On (Days and Dates)

Purpose of Rental: 

Hours of Program Approximate number to accommodated

Doors to be opened at (Renter will be charged 1/2 hour before and after for openeing and closing of building.)

If adminision fee is being charged, indicate amount $

I, the undersigned representative of the above named organization, have read teh regulations conerning community use of school prperperty  and agree that the organization, or persons, or person, making the request will adhere to there regulations.

I further state that the organization I represent does not discriminate against the handicapped.

The City of Quincy  and the Quincy School Committee are not responsible for injuries sustatined by users of this facility.  Applicants adn users of Gymnasiums and Facilities assume all risks of related injuries.

The signatory acknowledges receipt of Section 17, 18, & 19 of MGL Chapter 665 - attached here.

Signature:          

Home Telephone:

Cell/Work Telephone: 

Signee's Address:   

Email Address: 

Title IX Continueing Policy Statement

Quincy Public Schools does not discriminate on the basis of race, color, sex, religion or national origin in its educational activities or employment practices as required by Title IX of the 1972 Federal Edcuation Amendments.



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