Common use of AGREEMENT AND INSURANCE Clause in Contracts

AGREEMENT AND INSURANCE. The person or organization entering into this agreement with GCC for the use of facilities or equipment described above certifies that the information given in this application is current. The undersigned further states that he/she has the authority to make this application for the applicant and agrees that the applicant will observe all rules and regulations. The applicant further agrees to reimburse GCC for any damage arising from the applicant’s use of said facilities. Any accident involving injury to participants or damages to facilities or equipment occurring during the use of facilities or equipment will be reported to GCC authorities immediately. All users are required to provide proof of general liability coverage of no less than $1 million dollars per occurrence. The school and Gateway Community Charters must be named as additionally insured on said policy. Coverage cannot be canceled or reduced without thirty-(30) day’s written notice to GCC. The applicant agrees that GCC and its agents or employees will not be liable for any damage to person or property by reason of negligent acts of applicant, its agents, employees, invitees, or subcontractors. Applicant agrees to protect, indemnify for legal costs and other expenses, and hold harmless, the School District and its officers, employees, directors and agents from claims, liabilities, or suits, arising out of injury to person or property from negligent acts of applicant, directly or indirectly attributable to user’s activities and/or use of premises except for sole negligence of GCC. I have read the rules and regulations above on this form and agree with the conditions and charges as established: SIGNATURE OF APPLICANT DATE FOR DISTRICT USE ONLY Approved [ ] Disapproved [ ] Fee Group: [ ] 1 [ ] 2 [ ] 3 Certificate of Insurance Received [ ] Facility/Building Rental Fee $ Per Hour = $ Cleaning Deposit/Other Charges $

AGREEMENT AND INSURANCE. The person or organization entering into this agreement with GCC the School District for the use of facilities or equipment described above certifies that the information given in this application is current. The undersigned further states that he/she has the authority to make this application for the applicant and agrees that the applicant will observe all rules and regulations. The applicant further agrees to reimburse GCC the School District for any damage arising from the applicant’s 's use of said facilities. Any accident involving injury to participants or damages to facilities or equipment occurring during the use of facilities or equipment will be reported to GCC district authorities immediately. All users In accordance with Chapter 28A.335 RCW, private nonprofit groups serving youth are required to provide proof of bodily injury coverage of no less than $50,000 per occurrence/$100,000 aggregate. For-profit, business groups are required to provide proof of general liability coverage of no less than $1 million dollars per occurrence. The school and Gateway Community Charters School District must be named as additionally insured on said policy. Coverage cannot be canceled cancelled or reduced without thirty-(30) day’s 's written notice to GCCthe district. (Low-cost Special Events Liability Insurance is available through the school district's carrier.) _____________(initial) The applicant agrees to fully comply in accordance with the adoption of policies for the management of concussion and head injury in youth sports; as amended in RCW 4.24,660 and chapter 28A.600 RCW if applicable. Access to school facilities may not be granted until all requirements are complete and approved by the school district and/or designee. The applicant agrees that GCC the School District and its agents or employees will not be liable for any damage to person or property by reason of negligent acts of applicant, its agents, employees, invitees, or subcontractors. Applicant agrees to protect, indemnify for legal costs and other expenses, and hold harmless, the School District and its officers, employees, directors and agents from claims, liabilities, or suits, arising out of injury to person or property from negligent acts of applicant, directly or indirectly attributable to user’s 's activities and/or use of premises except for sole negligence of GCCthe School District. This is a legally binding document and applicant must be 18 or over. I have read the rules and regulations above and on the reverse side of this form and agree with the conditions and charges as established: SIGNATURE OF APPLICANT DATE Signature of Applicant Date: SEE REVERSE SIDE RULES AND REGULATIONS Applicant/organization is responsible for the safety and conduct of its participants and spectators. All non-profit youth sports group, verifies all coaches, athletes and their parent/guardian have complied with mandated policies for the management of concussions and head injuries as prescribed by HB 1824, section 2. Use of the kitchen facilities is prohibited by the facility user. If an end user does require use of food preparation services, the district may establish an hourly rate for the contracting of district trained staff responsible for food preparation, storage and service. Satisfactory sponsorship and adequate adult supervision must be provided by the applicant. Security may be required for some activities. All events will be required to meet the occupancy load and fire and safety regulations. Use of alcohol, tobacco, and/or drugs is prohibited. Profane language and/or other objectionable conduct may result in barred use of facilities. Firearms or other dangerous weapons are prohibited on school grounds as defined by law. Games of chance, lotteries, and giving of door prizes are not allowed except where permitted by law and then only with proper clearances. Access to facilities and services, except as otherwise addressed in these rules, shall be limited to that specified on the application. Alterations to the field/facility are prohibited without prior approval. This may include such things as hanging signs, erecting backstops, placing goals, using masking tape on walls and floors, etc. District-owned equipment shall not be removed from the facility or loaned to any individual or organization unless prior approval by the district has been granted. Groups or individuals cannot use district-owned expendable supplies. Applicants are responsible for special set-up requirements and clean up unless specifically requested in the application. Users shall be responsible for returning the facility to its original condition immediately following the event. Appropriate gym shoes are required for all activities on the uncovered floor of gymnasiums. The applicant/organization shall not practice discrimination of any kind. Cancellation; the user must notify the district with at least two days prior notice to avoid charges. Facility use is cancelled when facility/building is closed due to an emergency. The district reserves the right to refuse or revoke any authorization issued for the use of a school building or grounds, and if rental has been paid, to refund such rental less expense incurred by the district in connection therewith. No animals allowed with exception of service animals. Use of School Facilities Policy and Procedure Link: xxxxx://xxx.xxxxxxx.xxxxxx.xxx/documents/school-board/policies-%26-procedures/4000-community-relations/132241. If for any reason you will not be using the facility on the date requested, please contact: School Contact Person Phone Number Email High School / Junior High Xxxxxx Xxxxx 000-000-0000 xxxxxx@xxxxxxx.xxxxxx.xxx Acme Elementary Xxxxxxxx Xxxxxxxx 000-000-0000 xxxx@xxxxxxx.xxxxxx.xxx Harmony Elementary Xxxxxxx Xxxxx 000-000-0000 xxxxxx@xxxxxxx.xxxxxx.xxx Xxxxxxx Elementary Xxxxx Xxxxxxxx 000-000-0000 xxxxxxxxx@xxxxxxx.xxxxxx.xxx District Office Xxxxx Xxxxxxx 000-000-0000 xxxxxxxx@xxxxxxx.xxxxxx.xxx FOR DISTRICT USE ONLY Approved [ ] Disapproved [ ] Fee Group: [ ] 1 [ ] 2 [ ] 3 Certificate of Insurance Received [ ] Facility/Building Rental Fee $ Per Hour = $ Cleaning Deposit/Other Charges $ONLY

AGREEMENT AND INSURANCE. The person or organization entering into this agreement with GCC School District for the use of facilities or equipment described above certifies that the information given in this application is current. The undersigned further states that he/she has the authority to make this application for the applicant and agrees that the applicant will observe all rules and regulations. The applicant further agrees to reimburse GCC the School District for any damage arising from the applicant’s use of said facilities. Any accident involving injury to participants or damages to facilities or equipment occurring during the use of facilities or equipment will be reported to GCC district authorities immediately. All users In accordance with Chapter 28A.335 RCW, private nonprofit groups serving youth are required to provide proof of bodily injury coverage of no less than $50,000 per occurrence/$100,000 aggregate. For-profit, business groups are required to provide proof of general liability coverage of no less than $1 million dollars per occurrence. The school and Gateway Community Charters School District must be named as additionally insured on said policy. Coverage cannot be canceled cancelled or reduced without thirty-(30) day’s written notice to GCCthe district. (Low-cost Special Events Liability Insurance is available through the school district’s carrier.) (initial)The applicant agrees to fully comply in accordance with the adoption of policies for the management of concussion and head injury and sudden cardiac arrest awareness in youth sports; as amended in RCW 4.24.660 and chapter 28A.600 RCW and HB 5083, section 3 if applicable. Access to school facilities may not be granted until all requirements are complete and approved by the school district &/or designee. The applicant agrees that GCC the School District and its agents or employees will not be liable for any damage to person or property by reason of negligent acts of applicant, its agents, employees, invitees, or subcontractors. Applicant agrees to protect, indemnify for legal costs and other expenses, and hold harmless, the School District and its officers, employees, directors and agents from claims, liabilities, or suits, arising out of injury to person or property from negligent acts of applicant, directly or indirectly attributable to user’s activities and/or use of premises except for sole negligence of GCCthe School District. I have read the rules and regulations above and on the reverse side of this form and agree with the conditions and charges as established: established (this is a legally binding document and should only be signed by someone 18 years old or older): SIGNATURE OF APPLICANT DATE Date SEE REVERSE SIDE RULES AND REGULATIONS • Applicant/organization is responsible for the safety and conduct of its participants and spectators. • All non-profit youth sports group, verifies all coaches, athletes and their parent/guardian have complied with mandated policies for the management of concussions and head injuries as prescribed by HB 1824, section 2 and sudden cardiac arrest awareness as prescribed by SB 5083, section 3. • Satisfactory sponsorship and adequate adult supervision must be provided by the applicant. Security may be required for some activities. • All events will be required to meet the occupancy load and fire and safety regulations of the City of Seattle and State of Washington. • Use of alcohol, tobacco, and/or drugs is prohibited. Profane language and/or other objectionable conduct may result in barred use of facilities. • Firearms or other dangerous weapons are prohibited on school grounds as defined by law. • Games of chance, lotteries, and giving of door prizes are not allowed except where permitted by law and then only with proper clearances. • Access to facilities and services, except as otherwise addressed in these rules, shall be limited to that specified on the application. • Alterations to the field/facility are prohibited without prior approval. This may include such things as hanging signs, erecting backstops, placing goals, using masking tape on walls and floors, etc. • District-owned equipment shall not be removed from the facility or loaned to any individual or organization unless prior approval by the district has been granted. Groups or individuals cannot use district-owned expendable supplies. • Applicants are responsible for special set-up requirements and clean up unless specifically requested in the application. Users shall be responsible for returning the facility to its original condition immediately following the event. • Appropriate gym shoes are required for all activities on the uncovered floor of gymnasiums. • The applicant/organization shall not practice discrimination of any kind. • Cancellations by applicants require at least a 24 hour notice. Otherwise, related actual costs shall be borne by the applicant. • Facility use is cancelled when facility/building is closed due to an emergency. • The district reserves the right to refuse or revoke any authorization issued for the use of a school building or grounds, and if rental has been paid, to refund such rental less expense incurred by the district in connection therewith. FOR DISTRICT USE ONLY Single event [ ] School year [ ] Summer [ ] Days [ ] Evenings [ ] Saturday [ ] Sunday & Holiday [ ] Certificate of Insurance [ ] Requested [ ] Received Letter Compliance w HB1824 Concussion/Head Injury & SB5083 Sudden Cardiac Arrest [ ] Requested [ ] Received Building Administrator approval received [ ] *Approval signature should be on form or email attached. Approved [ ] Disapproved [ ] Fee GroupSignature of District/Building Facilities Coordinator Date Billing Information: Category: [ ] 1 A [ ] 2 B [ ] 3 Certificate of Insurance Received C [ ] D [ ] E [ ] F [ ] G [ ] H [ ] I Facility/Building Rental Fee $ Per Hour Staff Charges $ Rate x _ _ Hours = $_ Supplemental Fees: _ Total Billed $ Cleaning Deposit/Other Charges $LA XXXXXX SCHOOL DISTRICT # 311 SCHEDULE OF RATES FOR SCHOOL FACILITIES 2015-2016 CLASSIFICATION AUDITORIUM * GYM (per gym) KITCHEN/ CAFETERIA * COMMONS CLASSROOMS FIELD (per field)

AGREEMENT AND INSURANCE. The person or organization entering into this agreement with GCC School District for the use of facilities or equipment described above certifies that the information given in this application is current. The undersigned further states that he/she has the authority to make this application for the applicant and agrees that the applicant will observe all rules and regulations. The applicant further agrees to reimburse GCC the School District for any damage arising from the applicant’s use of said facilities. Any accident involving injury to participants or damages to facilities or equipment occurring during the use of facilities or equipment will be reported to GCC district authorities immediately. All users In accordance with Chapter 28A.335 RCW, private nonprofit groups serving youth are required to provide proof of bodily injury coverage of no less than $50,000 per occurrence/$100,000 aggregate. For-profit, business groups are required to provide proof of general liability coverage of no less than $1 million dollars per occurrence. The school and Gateway Community Charters School District must be named as additionally insured on said policy. Coverage cannot be canceled cancelled or reduced without thirty-(30) day’s written notice to GCCthe district. (Low-cost Special Events Liability Insurance is available through the school district’s carrier.) (initial)The applicant agrees to fully comply in accordance with the adoption of policies for the management of concussion and head injury and sudden cardiac arrest awareness in youth sports; as amended in RCW 4.24.660 and chapter 28A.600 RCW and HB 5083, section 3 if applicable. Access to school facilities may not be granted until all requirements are complete and approved by the school district &/or designee. The applicant agrees that GCC the School District and its agents or employees will not be liable for any damage to person or property by reason of negligent acts of applicant, its agents, employees, invitees, or subcontractors. Applicant agrees to protect, indemnify for legal costs and other expenses, and hold harmless, the School District and its officers, employees, directors and agents from claims, liabilities, or suits, arising out of injury to person or property from negligent acts of applicant, directly or indirectly attributable to user’s activities and/or use of premises except for sole negligence of GCCthe School District. I have read the rules and regulations above and on the reverse side of this form and agree with the conditions and charges as established: established (this is a legally binding document and should only be signed by someone 18 years old or older): SIGNATURE OF APPLICANT DATE Date SEE REVERSE SIDE RULES AND REGULATIONS • Applicant/organization is responsible for the safety and conduct of its participants and spectators. • All non-profit youth sports group, verifies all coaches, athletes and their parent/guardian have complied with mandated policies for the management of concussions and head injuries as prescribed by HB 1824, section 2 and sudden cardiac arrest awareness as prescribed by SB 5083, section 3. • Satisfactory sponsorship and adequate adult supervision must be provided by the applicant. Security may be required for some activities. • All events will be required to meet the occupancy load and fire and safety regulations of the City of Seattle and State of Washington. • Use of alcohol, tobacco, and/or drugs is prohibited. Profane language and/or other objectionable conduct may result in barred use of facilities. • Firearms or other dangerous weapons are prohibited on school grounds as defined by law. • Games of chance, lotteries, and giving of door prizes are not allowed except where permitted by law and then only with proper clearances. • Access to facilities and services, except as otherwise addressed in these rules, shall be limited to that specified on the application. • Alterations to the field/facility are prohibited without prior approval. This may include such things as hanging signs, erecting backstops, placing goals, using masking tape on walls and floors, etc. • District-owned equipment shall not be removed from the facility or loaned to any individual or organization unless prior approval by the district has been granted. Groups or individuals cannot use district-owned expendable supplies. • Applicants are responsible for special set-up requirements and clean up unless specifically requested in the application. Users shall be responsible for returning the facility to its original condition immediately following the event. • Appropriate gym shoes are required for all activities on the uncovered floor of gymnasiums. • The applicant/organization shall not practice discrimination of any kind. • Cancellations by applicants require at least a 24 hour notice. Otherwise, related actual costs shall be borne by the applicant. • Facility use is cancelled when facility/building is closed due to an emergency. • The district reserves the right to refuse or revoke any authorization issued for the use of a school building or grounds, and if rental has been paid, to refund such rental less expense incurred by the district in connection therewith. FOR DISTRICT USE ONLY Single event [ ] School year [ ] Summer [ ] Days [ ] Evenings [ ] Saturday [ ] Sunday & Holiday [ ] Certificate of Insurance [ ] Requested [ ] Received Letter Compliance w HB1824 Concussion/Head Injury & SB5083 Sudden Cardiac Arrest [ ] Requested [ ] Received Building Administrator approval received [ ] *Approval signature should be on form or email attached. Approved [ ] Disapproved [ ] Fee GroupSignature of District/Building Facilities Coordinator Date Billing Information: Category: [ ] 1 A [ ] 2 B [ ] 3 Certificate of Insurance Received C [ ] D [ ] E [ ] F [ ] G [ ] H [ ] I Facility/Building Rental Fee $ Per Hour Staff Charges $ Rate x Hours = $ Cleaning Deposit/Other Charges $Supplemental Fees: Total Billed $ LA XXXXXX SCHOOL DISTRICT # 311 SCHEDULE OF RATES FOR SCHOOL FACILITIES 2015-­‐2016 CLASSIFICATION AUDITORIUM * GYM (per gym) KITCHEN/ CAFETERIA * COMMONS CLASSROOMS FIELD (per field)

AGREEMENT AND INSURANCE. The person or organization entering into this agreement with GCC the School District for the use of facilities or equipment described above certifies that the information given in this application is current. The undersigned further states that he/she has the authority to make this application for the applicant and agrees that the applicant will observe all rules and regulations. The applicant further agrees to reimburse GCC the School District for any damage arising from the applicant’s 's use of said facilities. Any accident involving injury to participants or damages to facilities or equipment occurring during the use of facilities or equipment will be reported to GCC district authorities immediately. All users In accordance with Chapter 28A.335 RCW, private nonprofit groups serving youth are required to provide proof of bodily injury coverage of no less than $50,000 per occurrence/$100,000 aggregate. For-profit, business groups are required to provide proof of general liability coverage of no less than $1 million dollars per occurrence. The school and Gateway Community Charters School District must be named as additionally insured on said policy. Coverage cannot be canceled cancelled or reduced without thirty-(30) day’s 's written notice to GCCthe district. (Low-cost Special Events Liability Insurance is available through the school district's carrier.) _____________(initial) The applicant agrees to fully comply in accordance with the adoption of policies for the management of concussion and head injury in youth sports; as amended in RCW 4.24,660 and chapter 28A.600 RCW if applicable. Access to school facilities may not be granted until all requirements are complete and approved by the school district and/or designee. The applicant agrees that GCC the School District and its agents or employees will not be liable for any damage to person or property by reason of negligent acts of applicant, its agents, employees, invitees, or subcontractors. Applicant agrees to protect, indemnify for legal costs and other expenses, and hold harmless, the School District and its officers, employees, directors and agents from claims, liabilities, or suits, arising out of injury to person or property from negligent acts of applicant, directly or indirectly attributable to user’s 's activities and/or use of premises except for sole negligence of GCCthe School District. This is a legally binding document and applicant must be 18 or over. I have read the rules and regulations above and on the reverse side of this form and agree with the conditions and charges as established: SIGNATURE OF APPLICANT DATE FOR DISTRICT USE ONLY Approved [ ] Disapproved [ ] Fee GroupSignature of Applicant Date: [ ] 1 [ ] 2 [ ] 3 Certificate SEE REVERSE SIDE RULES AND REGULATIONS Applicant/organization is responsible for the safety and conduct of Insurance Received [ ] Facilityits participants and spectators. All non-profit youth sports group, verifies all coaches, athletes and their parent/Building Rental Fee $ Per Hour = $ Cleaning Depositguardian have complied with mandated policies for the management of concussions and head injuries as prescribed by HB 1824, section 2. Use of the kitchen facilities is prohibited by the facility user. If an end user does require use of food preparation services, the district may establish an hourly rate for the contracting of district trained staff responsible for food preparation, storage and service. Satisfactory sponsorship and adequate adult supervision must be provided by the applicant. Security may be required for some activities. All events will be required to meet the occupancy load and fire and safety regulations. Use of alcohol, tobacco, and/or drugs is prohibited. Profane language and/or other objectionable conduct may result in barred use of facilities. Firearms or other dangerous weapons are prohibited on school grounds as defined by law. Games of chance, lotteries, and giving of door prizes are not allowed except where permitted by law and then only with proper clearances. Access to facilities and services, except as otherwise addressed in these rules, shall be limited to that specified on the application. Alterations to the field/Other Charges $facility are prohibited without prior approval. This may include such things as hanging signs, erecting backstops, placing goals, using masking tape on walls and floors, etc. District-owned equipment shall not be removed from the facility or loaned to any individual or organization unless prior approval by the district has been granted. Groups or individuals cannot use district-owned expendable supplies. Applicants are responsible for special set-up requirements and clean up unless specifically requested in the application. Users shall be responsible for returning the facility to its original condition immediately following the event. Appropriate gym shoes are required for all activities on the uncovered floor of gymnasiums. The applicant/organization shall not practice discrimination of any kind. Cancellation; the user must notify the district with at least two days prior notice to avoid charges. Facility use is cancelled when facility/building is closed due to an emergency. The district reserves the right to refuse or revoke any authorization issued for the use of a school building or grounds, and if rental has been paid, to refund such rental less expense incurred by the district in connection therewith. No animals allowed with exception of service animals.