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Form Page: FacilitiesUsageRequest
Facility And Event Information
Organization / Contact Information
Note: If your oganization is a church, you must have been in existance for at least 3 years. You must also provide state proof of incorporation. If you are a 501C3 organization you must also provide state proof of incorporation.
After Hour Use / Access
Start
End
Days
Hrs/Day
Audio Visual
Custodial
Child Nutrition
Room
Total
Fees .. (Room/Location 1)
Click here to open the date picker
Click here to open the date picker
Start
End
Days
Hrs/Day
Audio Visual
Child Nutrition
Custodial
Room
Total
Fees .. (Room/Location 2)
Click here to open the date picker
Click here to open the date picker
Start
End
Days
Hrs/Day
Audio Visual
Custodial
Room
Child Nutrition
Total
Fees .. (Room/Location 3)
Click here to open the date picker
Click here to open the date picker
Start
End
Days
Hrs/Day
Audio Visual
Custodial
Room
Child Nutrition
Total
Fees .. (Room/Location 4)
Click here to open the date picker
Click here to open the date picker
Start
End
Days
Hrs/Day
Audio Visual
Custodial
Total
Room
Child Nutrition
Fees .. (Room/Location 5)
Click here to open the date picker
Click here to open the date picker
Insurance Information
The organization making use of any District facility shall secure and maintain, at its expense, during the term of the agreement, general liability insurance with a company licensed by the State of Alabama, and have an A.M. Best Rating of “A” or better. An Accord Certificate of Insurance shall be furnished with each rental and shall be presented to the District with a signed permit and payment. The certificate shall show on its face the following:

1. The Birmingham Board of Education, Birmingham City Schools, Superintendent and their officers, employees and agents named and as additional Insured.
2. Property damage in the amount of $1,000,000 per occurrence
3. Personal injury liability (to include participants in the activity) in the amount of $1,000,000 per occurrence.
Financial Information
All rental fees must be paid by money order or certified check to the Birmingham Board of Education at least one week (7) days in advance of the date of use of the district’s facilities and/or grounds. The money order or certified bank check should be hand-delivered or sent by registered mail (must be received prior to date of event) to Birmingham Board of Education, Department of Finance, Room 204, 2015 Park Place North, Birmingham, Alabama 35203.