Southwest Technology Center
Request and Hold Harmless Agreement
For Use of School Property

Please complete this form and send to Southwest Technology Center, 711 W Tamarack, Altus OK 73521 or FAX to 580-477-0139

Request for use of facility on: 

Times needed (please be specific): 

Sponsoring group or organization: (Invoice will be mailed to this address)

Name:     

Address: 

City:        State/Zip: 

Contact Person:

Name:     

Phone #:      Cell #(s): 

Fax #:           E-mail: 

Purpose and Description of Use:

Are you charging an admission fee for attendees?               Yes       /          No           (circle one)

Number anticipated attending event:      (determines room(s) needed)

Equipment needed: video projector, TV, microphone, vcr/dvd etc.( fees may apply)

We are limited on equipment available for use during the school year; therefore it is important to request any equipment you may need. It is not guaranteed it will be available on the day needed if not reserved in advance.

The following stipulations apply:

The undersigned user of school facilities hereby agrees that he/she has authority to bind the sponsoring group or organization or individual users to:

1. Observe the rules and regulations for the use of school facilities as established in adopted Board policy, a copy of which is located at www.swtc.org

2. Assume full responsibility for loss/or damage to school district property resulting from such use. 

3. Assume full responsibility for personal injury or property damage sustained by any person as a result of such use, waive all school district liability for such injury, and agree to hold the district harmless from any and all claims of whatever nature which may be brought against the district arising from the user's use of the school premises.

4. Please note that we have short-term evening classes on most evenings and the rooms are not available for overnight use therefore you may need to secure/remove your materials.  If reserving a classroom for multiple days and arrangements are made in advance the rooms can be reserved overnight for an additional fee.

5. Pay the usual and customary fee for such use as requested in accordance with the fee schedule for the requested facilities, equipment, required technician, and other fees, as required, in accordance with regulations.

Those fees are identified and total:  $              .      

6. Signing this statement assures the school district that the sponsoring group or organization has read and understands the Board policies on school use and will inform all individual users that use is not for a school function and will not be supervised by the district

Signature of Person Making Request                                                               Date

Rodger Kerr, Director Business & Industry                                                    Date