Facility Agreement
Name of Requestor
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First Name
Last Name
Company Name/Group Name
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Reason for Renting the Facility
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Please Select
MA Team Lock-In
Church/Youth Group/Ministry Event
Non-MA Youth Team Practice (AAU,Club VB, Travel BB & SB, etc.
Non-MA Tournament (AAU,Club VB, Travel BB & SB, etc.
MA Constituent- Request to use facility for adults.
MA Constituent- Request to use facility for one on one instruction.
Estimated Number of Teams Attending Tournament
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Estimated Number of People Attending This Event
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The User(s) agrees that all instruction will only be one on one between instructor and one athlete.
I agree
Check the following facility(ies) you would like to use:
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Lower Gym
Upper Gym
Basketball Concession Stand
Little MA Gym
Baseball Field
Softball Field
Baseball/Softball Concession Stand
Soccer Field
Football Practice Field
Football Field
Football Concession Stand
Tennis Courts
If you are an organization, please upload a PDF copy of your organizations Certificate of General Liability stating that Madison Academy has been named as an additional insured for the duration of their use of our facilities. If you are an individual, please upload a PDF copy of your personal insurance card.
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Upload a File
Cancel
of
Duration of Rental
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I would like to make a one time rental request.
I would like to make a recurring rental request.
The facility(ies) will be available for use on the following dates and time.
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AM/PM Option
The facility(ies) will be done with activities on the following date and time.
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Monthly Rental
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February
March
April
May
June
July
August
September
October
November
December
The User(s) agrees to pay the agreed upon rental fee before using the facility.
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I agree
The User(s) agrees to check out a key from the Athletic Department, agrees not to share this key with anyone, and agrees to return the key at the appropriate time or face a fine.
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I agree
For the purposes of this agreement, the User(s) to use only those parts of Madison Academy buildings or grounds specified above, and the entrances to those parts.
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I agree
The User(s) is to ensure that any furniture and equipment moved during use of the premises is replaced, that the premises will be left in a clean and tidy condition, that proper care will be taken of the premises during use and any damage from such use, whether caused by negligence, recklessness or the willfulness of the User(s), or the servants, agents or invitees of the User/s), is repaired at the User(s) own cost.
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I agree
Madison Academy reserves the right to terminate this agreement immediately by notice in writing at its absolute discretion if clause 6 is contravened by the User(s) (or the servants, agents or invitees of the User(s)) at any time.
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I agree
The User(s) shall maintain throughout the term of this agreement insurance policies as noted on the attached Insurance Requirements with a reputable insurer, having an A. M. Best rating of A- or better, in which (a) Madison Academy is indemnified in an amount not less than $1 million for any claims whatsoever (including injury to persons or damage to property) arising out of the use of Madison Academy premises by the User(s); (b) Madison Academy is named as an Additional Insured under the policy; and (c) the policy or a certificate of insurance must be produced to Madison Academy prior to use of the facilities. User(s) and Madison Academy agree that any insurance policies procured by User(s) that provide benefits or protection for Madison Academy shall be primary and that any policies procured by Madison Academy that might happen to provide protection or benefits to Madison Academy arising out of User’s use of Madison Academy premises shall be excess.
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I agree
The User(s) must give written notice to Madison Academy of any accident resulting in bodily injury or damage to property of Madison Academy or others occurring on Madison Academy premises or in any way connected with the use of Madison Academy premises within 24 hours of the accident. The notice must include details of the time, place and circumstances of the names and addresses of any person(s) witnessing the accident.
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I agree
The User(s) agrees that no hazardous materials, including but not limited to, flammable materials or liquids, fireworks, pyrotechnic devices, explosives, poisonous materials or plants, strong acids or caustics, or dangerous animals will be brought onto the premises or used in any way while occupying any portion of any Madison Academy owned property.
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I agree
The User(s) agree that no amusement rides or attractions, including but not limited to, trampolines of any type, enclosed or air supported structures of any type, climbing walls, climbing ropes, firearms or shooting activity, bow and arrow shooting activity or equipment or devices related thereto will be brought onto the premises or used in any way while occupying any portion of any Madison Academy owned property.
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I agree
In addition, the User(s) undertakes and agrees to indemnify and hold harmless Madison Academy, Madison Academy Board of Directors, Madison Academy elected and appointed officials, administrators, principals, teachers and all other school employees, volunteers or representatives, and all persons and bodies corporate acting for or on behalf of them, against all liability, claims, demands, actions, suits, damages, proceedings, costs and expenses (including reasonable attorney fees) whatsoever (including injury to persons and damage to property) for which they may be or become liable directly or indirectly arising out of the use of Madison Academy premises by the User(s) (or the servants, agents or invitees of the User/s)), and for such further sums in excess of those contained in any insurance policy procured by User(s) relating to the use of Madison Academy premises or for such amounts as may not be payable under any such insurance policy.
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I agree
By signing below I agree to all of the terms listed above.
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To sign your name place cursor over signature line, hold down your finger on the trackpad, and then sign your name.
Please type the name of the person signing above.
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Today's Date
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Month
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Day
Year
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Contact Person
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First Name
Last Name
Title of Contact Person:
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Cell Phone Number
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Area Code
Phone Number
E-mail
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Please enter the amount the Athletic Director approved
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