18-107.00 Central Valley School District: Use of High School Tennis CourtsCENTRAL VALLEY
SCHOOL DISTRICT/756
Permit for Use of
School Facilities & Playfields
Organization or Team arYcP qtoire vAtei
PARYS RAcKEA-7140 - 44/1.6*** TE.H1-1/5 c611.P
Person in Charge 11114 1 Y1`f
Address 2426 N. DlgattsY POGE.
City SitiME VALLEY State CePi Zip ¶2I6
Phone 501-72o- 540$
Email 4'9VP (Jsewe srecutc✓ailoy.Org.
Date
6/54
School CF347/0L- VALLEY 6//64 Sq49:1- (-WF )W 1.116(4
Field, Diamond or Facility 41V Carg5
Starting Date JCJI Y 2/ 20G Time 1 "- 12N
Ending Date 4$7. ?/ 2018 Time %M- ( 4i4
Week(s) of Event %/4060-1E1) 54tExcE
Day(s) of Week A464- FR/
Doors Open RA A M IVA
P.M.
Activity Classification
from Board Policy #4260
Fee
from Administrative Procedure #4260AP
Insurance
❑ Class 1 Box No. (1-24)
Use Fee per Hour $
❑ Yes Certificate of Insurance
*1
Custodian' hrs X $ hr =
for all use is with district.
❑ Class 11 Box No. (25-48)
_
Name
❑ Yes Organization's Certificate
Food Serv: hrs X $ hr-
of Insurance attached. "2
❑ Class III
Name
❑ Yes Individual/Parent Hold
Admission Charge
Other Staff hrs X $ hr=
Harmless Agreement
Expected Attendance
Name
Signed. ***3
Estimate User Cost: $
*1. YMCA/SoccerAssociation/AAU/County Parks/et cetera
**2. Scouts, 4-H, SCOPE, Percussionauts, Club sports, Grange, Church groups, et cetera
***3. Individuals who may not be insured with an insurance company
Explanation and/or special conditions (Users provide their own sanitary facilities) CV c) L &Me t Imo`
Hold Harmless Agreement
The undersigned agrees and acknowledges that the use of the facilities of Central Valley School District No. 356 is without representation or warranties by the school district,
its employees and agents, as to the condition of the property. The undersigned agrees to take full responsibility for any and all damage to the property and/or injury to
persons allowed or reasonably anticipated to be on the premises by the undersigned. The undersigned specifically waives any and all rights, remedies, or causes of action
against Central Valley School District No. 356, Its employees and agents, from any and all claims arising out of the use of the premises and agrees to reimburse the school
district for any and all judgements, costs and expenses, including attorney's fees, incurred by the school district in the defense of any such action.
The undersigned further agrees and warrants that should the respective organization or group use school district facilities, and serve or prepare any food or beverage, it
shall comply with all applicable federal, state and local laws and regulations regarding the serving and preparation of such food or beverage. The undersigned organization
specifically agrees to contact the Spokane County Health District in order to ensure that all required regulations and requirements are met, including, but not limited to, any
applicable food pemtit that Is required to be obtained.
agree that the above information is correct and the building facilities will be used according to the policies and procedures of the Central Valley School District
further agree to reimburse the school district for actual user costs as described in the final billing.
, a private 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.
Attached is a proof of insurance under an accident and liability policy issued by an insurance company authorized to do business in Washington State
covering any injury or damage with at least $1,000,000 due to bodily injury or death to one person and at least $2,000,000 due to bodily injury or death
to two or more persons.
Dated thi(( day of Nkk-t — 20
�CiYef •VPAIE VALLEY
Name of Individual/Organization/Team
white: District Business Office
Yellow: Organization/Team
Pink: Principal
Note: Access to school facilities may not be granted until all requirements of this
application are complete and approved by the school district and/or designee.
C'
Person Authorized to Sign
School Principal
4260 F
Revised 3/2011
3
9am — 12pm = half day 'camp
9arn —., 3pm = full day.camp 0
•
**New .camps available at, Valley Mission Park, 11123 E. Mission
•
MULT1-SPORTCAMP (SOCCER, BASKETBALL, &BASEBALL). •
Course# Dates. Time Ages Fee Location
SSA101285 ' June 18-22 •.9am,-- 3pm 6-12 yrs $139. TerraceView
SSA101361 Aug 13-17 •9am — 12pm 6-12 yrs • $125 TerraceView
SSA101406 Aug 13-17 9am — 3pin 6-12 yrs $139 Terrace View
*WIC steal "°;t'yvharfio! rpm
hew* oUcIi10
,dProf en'arne
h Vit f esson as e -to pl.iVoilk our self, Ise I
43t,ttlitt,
MINI•KAWK CAMP (SOCCER,• BASEBALL .0 BASKETBALL)
Courte# Dates Time . Ages Fee Location.
SSA101290 Jane 25-29 9am— 12pm • 44 yrs $125 TerraceView
SSA.101291 July16-20 9am-12pin 4-7 yrs $125 TerraceView
A" or
1 es .ehiterre
„ P
• 9,tp , . ,,•4,f, .,,,
are tau, ed e v"'
',441X IN. S
. . .
FLA FOOTBALL;AMP:,
Course# Dates . Time Ages , *Fee ' , Location
SSA102052 June 25.:29. .9aM,12pin • 6-12 yrs ..- . $125 ' : Valley Mission
SSA101286 July 23-27 , ... -9ain:3Pm • 6-12 yrs • $139 Terrace View
SSA101287 July 23-27 • - 9am l': 12pm 6-12 yrs , $125 . ' TerraceView
SSA1020490 • June.229.: ' '..9atri•--.3pui ,..,12yrs • $1:39 Valley Mission
gfiRrnkazzoNl5iT,am*-
osh rs, s p latolathletieS
; 40-4-thzito,,1105,141,2,a
gipm w th lots).Offir coUragernen,
,ott- •
la: .4.
This mu1ti-spoa program gives chitdren a positivefIrststpencouragement and afocus onfun„
0
, . .
KULTOPORT.OTIYikiTg RUSHEE,CAPTURE TR.FLAG ANDDOPPPIALO
Course# Dates :two • Ages • , Fee, . '1.:«r,g4on ” •
S,SA.101288 Jul00-Ang 3 9am;--3pui , 6-12 yrs $139 Terrac,cVieW
SSA:101292 July 30 -Aug 3 9am— 12,n 6-12 yrs $125 TerraceView •
This program will introduce youth athletes to a variety of different sports in one
setting. .Learn the rules and essentials of each sport through skill -based games
and sdrirninagess. By the end of the week, your child will walkaway With:
knowledge of multiple sports along with vital life lessons such as respect,
miwkop wa7; ,, ,
qt.e. eR-04,940.511STA„
n4.01,,a4itiPleatG a ; ,10' .;
IMPAIttbigtf,ri.: w
4
de e
SOCCER CAMP.
,Course# Dates . • Time, -•.' Ages Fee •
0SSA10126. July. 9-13. ' 9am-3pm • 6-12 yrs* $1.39
. SSA101284. July 9-13 9am-12pm 6-12 Yrs $125
SSA101359 Aug 6-10 . 9am —3pm* 6-12 yrs $139
• SSA -101360 Aug 6-10 -Pain 121),ifi • • 6-12 yrs 0 $125
Location
Terrace View
Teirace View
TerraceView
• TerraceView
5057,roxionms low makiwgii,vomtgo,'...ffog
s 'f 'tam ea',0,4431ietinneanietitillsocce
curca, iteliffritirattki*J'I'8,441ha
-,edA oro rat e, tepa %Soccer...
4.,2-twestrantm as • ',31.46'.;,,-13,44,0•.
8
•
TRACK AR FIELD CAMP
Co‘ofr Dates Time Ages tee Location;
SSA101435 Jai), 16-20' 9a -12p ni • 6-12 yrs $125 TerratiView •
SSA102048, July 16-20 9am 7 3pm • 6712 yrs $139 TerraceView'
CombineS technical. development, fundamental techniques; and 'safety with a
majorfocus on FUN! Using special equipment, Skyhawks covers the fundamentals
of body positioning stride, proper stretching and cobl-dow.n techniques.
EELEADRW e
oume#
0 ey;Mission,..,
:•4-1--.,,,,...-.. -,'.•:,.
al ey:-,MISSIOLb
errace View' .:,• :
y. , ,s1Nyill-„epsktro , ,i.eatIvam eers,,.pf0.Per! • a
ovements as 3iVetlz,aS;:ij0Mping:technrqpeS-;,,ThOre;,is;no:?Stil)ptin
fun whte '.':Cheerteader4,earti-S.Attrip.orta.
andeanbwLding:.,Ldd}sii
s
2018 Spring/Sumnier Recreation Guide