DECLARATION OF APPLICANT:
HOLD HARMLESS & INDEMNIFICATION AGREEMENT
THE UNDERSIGNED AGREES TO DEFEND, INDEMNIFY AND HOLD HARMLESS THE NOVATO UNIFIED SCHOOL DISTRICT, ITS BOARD OF TRUSTEES, AGENTS AND
EMPLOYEES, INDIVIDUALLY AND COLLECTIVELY, FROM AND AGAINST ALL COSTS, LOSSES, CLAIMS, ACTIONS, AND JUDGMENTS ARISING FROM PERSONAL INJURIES,
PROPERTY DAMAGE OR OTHERWISE, HOWEVER CAUSED, THAT MAY ARISE FROM OR BE ALLEGED TO BE CAUSED BY THE UNDERSIGNED’S USE OR OCCUPANCY OF
DISTRICT FACILITIES, FURNITURE OR EQUIPMENT.
THE UNDERSIGNED FURTHER AGREES TO PROVIDE A CERTIFICATE OF INSURANCE FOR LIABILITY COVERAGE SATISFACTORY TO THE DISTRICT
FACILITIES USE GUIDELINES
1. All groups using N O V A T O U N I F I E D S C H O O L D I S T R I C T facilities must complete and sign
this application, which includes a hold harmless statement.
2. C E R T I F I C A T E O F I N S U R A N C E R E Q U I R E D :
a. N O V A T O U N I F I E D S C H O O L D I S T R I C T must be named as additional insured
b. Minimum coverage requirement: $1,000,000.00 (ONE MILLION) Combined Single Limit
3. All activities on District property must be supervised at all times. All juvenile organizations or
groups must have constant adult supervision.
4. Please help us take care of our school property and equipment and protect it from damage and
mistreatment. Your organization is responsible for property and equipment damaged beyond
normal wear. Cleanliness is also important and we are counting on you to clean up after your
event. You will be charged for any cleaning should it be required.
5. Chairs and table are standard equipment for meeting rooms. Any additional equipment
required must be requested on your application form. The use or loan of portable equipment
will be permitted only if such use is under direct supervision of an authorized representative of
6. The use of alcohol, drugs and tobacco products is strictly prohibited on District property
including buildings and grounds.
7. If you need to cancel a scheduled meeting, please notify the Facilities Coordinator at
415-898-6001 at least 48 hours prior to the meeting time. You will be charged for any expenses
incurred by the District should you not meet cancellation deadlines.
8. If we need to cancel your activity due to District conflict, a replacement application will be
supplied free of charge. We will give you five days notice of cancellation.
In emergencies, permits may be revoked at any time upon notice.
9. The District reserves the right to refuse the use of the facility for a group which has previously
violated any of the district rules or regulations.