Knight High School

37423 70th St. East, Palmdale, CA 93552

Phone: 661-533-9000 Fax: 661-533-0111

*REQUESTS MUST BE SUBMITTED 48 HOURS IN ADVANCE*

Facility Request Form
Date Of Application:	Click or tap to enter a date.	Date(s) Facility To Be Used:	Click or tap to enter a date.
Expected Attendance:	Click or tap here to enter text.	Time Facility Will Be Used:	Click or tap here to enter text.
Event Starts At:	Click or tap here to enter text.	Rehearsal Date/Time:	Click or tap here to enter text.
Event Name/Purpose:	Click or tap here to enter text.

PLEASE CHECK BOX FOR FACILITY NEEDED: *Outside organizations will need to provide a policy naming the Antelope Valley Union High School District, their officers, agents, employees, and volunteers as additionally insured in the amount of one million dollars. Coverage MUST be for the date(s) of use.
☐COMMONS STAGE	☐ THEATER	☐ STAFF LOUNGE
☐ STADIUM	☐ CHORAL ROOM	☐ LIBRARY
☐ TRACK/FIELD	☐ BAND ROOM	☐ SMALL GYM
☐ PRACTICE FIELD	☐ CAFETERIA	☐ LARGE GYM
☐ COMMONS AREA	☐ LOCKER ROOMS	☐ OTHER: Click or tap here to enter text.
☐ CLASSROOMS:	☐ GREEN ROOM

EQUIPMENT NEEDED:
☐ PA SYSTEM	☐ PIANO	☐ SECURITY
☐ PROJECTOR/SCREEN	☐ RISERS	☐ LECTURN/PODIUM
☐ MUSIC STANDS	☐ ASB SOUND SYSTEM (Activities will contact ASB for request)	☐ TABLES:
☐ CHAIRS: Click or tap here to enter text.	☐OTHER: Click or tap here to enter text.
OTHER/NEEDED: Click or tap here to enter text.
Name of Organization: Click or tap here to enter text.	Phone: Click or tap here to enter text.
Address: Click or tap here to enter text.	E-mail: Click or tap here to enter text.
Representative: Click or tap here to enter text.
An Admission Fee, or Solicitation Funds: ☐ WILL ☐ WILL NOT Be Made	Amount: $ Click or tap here to enter text.
The Net Proceeds Will Be Used For: Click or tap here to enter text.
We hereby certify that we shall be personally responsible, on behalf of our organization, for any damage or unnecessary abuse of school buildings, grounds, or equipment growing out of the occupancy of said premises by our organization. We agree to abide by and enforce the rules and regulations of the Antelope Valley Union High School District governing the non-school use of buildings, grounds, and equipment as attached to applicant’s copy. The undersigned also has signed a statement of information. The group will receive its approved copy of the application through phone, e-mail, or mail.
Request Completed by: Click or tap here to enter text.	Title:Click or tap here to enter text.

ACTIVITIES OFFICE USE ONLY
Approved: ☐ Denied: ☐ School Dude #Click or tap here to enter text.	Date: Click or tap to enter a date.
If denied, representative will be notified by email.

*ALL FIELDS ARE REQUIRED TO BE FILLED IN*