Facilities Usage Request Form


1. Organization Information

2. Designated Representative

6. Special Services or Equipment Required

Please contact catering manager, Debra Zacherl at catering@clarion.edu for menu, pricing, and reservations.


Organizations will be assessed a rate-per-hour fee for use of the facility in addition to charges for maintenance and custodial services that may be applicable in relation to the activity. Waiver or reduction of this hourly fee may be requested, in writing, to the Director of Residence Life and Auxiliary Services, 216 Becht Hall, Clarion University of Pennsylvania, Clarion, PA 16214. At minimum, 50 percent of the total assessed fee must accompany the formal agreement for use with the remainder being due no later than 10 days following the activity, unless other payment arrangements have been agreed upon. If the event is cancelled by the requesting party less than seven days before the scheduled date of the activity, the university reserves the right to retain 10 percent of the total estimated fees plus any direct costs incurred by the university in preparation for the event with any balance being returned to the organization.

If the hourly fee for use of the facility is waived, actual out-of-pocket expenses for custodial charges for preparation for and clean-up after the activity and maintenance services may still be assessed at the discretion of the university. Estimates of these charges shall be included in the agreement.

Availability of parking for participants in approved programs is not guaranteed by the university. Large groups should consider shuttle service or carpooling. The Office of Conference & Event Services will work with Public Safety to secure parking permits for external events. The Organization should notify the Office of Conference & Event Services of the number of parking permits it needs for its attendees at least 14 days prior to the event. There will be a $2 charge for each permit.

Organizations using the pool are required to have certified lifeguards present to supervise their activity. These lifeguards shall be considered part of your group and must be covered under your liability insurance. The organization is responsible for any amount due for their services which is payable on the date of your activity. The athletic department can provide groups with a list of individuals that they know to be certified. If you are supplying a lifeguard that is not on this list then you must submit proof of certification to our office prior to your use of the facility. If these requirements are not met your group will be denied access to the pool. 

Only university security personnel may be used at scheduled events without prior written consent of the university.

The university reserves the right to assign a university representative to be present at the event when it deems such additional supervision is necessary and advisable.

The organization must provide the university with certificates of insurance with Clarion University of Pennsylvania named as an additional insured and covering property damage liability and bodily injury in amounts of no less than $500,000 per person and $1 million per incident. The university must be named as an additional insured on any such certificate, and the certificate shall provide that the insurance carrier will provide advance notice to the university of any termination, cancellation or discontinuance or modification in coverage of the insurance. The university reserves the right to raise these limits, as it deems necessary based on the activity being conducted. Certificates shall be returned to the university with the required agreement form or in any case no later than one week prior to the planned activity. Access to the facility will be denied if certificates have not been furnished prior to the date of the activity. Furthermore, the applicant shall hold the university harmless from any and all liability arising from the activity held on university premises. Athletic organizations hosting events on or in campus facilities may require additional certificates of insurance.

Organizations must adhere to all fire and safety codes and regulations.

Utility installations, connections, extensions or adaptations shall not be made without the approval of the Director of Facilities Management or designee.

Light and switch panels, staging, electrical, electronic and public address systems shall not be operated without the direct approval of the Director of Facilities Management or designee.

The organization is restricted to the use of those areas specified in the agreement.

No alcoholic beverages are permitted on campus.

Serving of food and refreshments is restricted to areas approved in advance by the Office of the Vice President for Student Affairs.

Clarion University reserves the right to remove any individual(s) for unruly behavior. The Department of Public Safety in consultation with university administration will determine the appropriate actions to be taken.

All advertising for this activity must be approved in advance by the Vice President for Student Affairs. All advertising must contain the statement, "This is not a Clarion University - affiliated event." This information is to be submitted to the Director of Auxiliary Operations, 206 Egbert Hall.

If minors are present at event and are not in direct supervision of parent or legal guardian, then all adults with direct contact must be included on the External Organization Clearance Verification form. (Available from the Conference and Events office). If the event is open to the general public, it is exempt from this policy.

The organization is to make all adults working with the event aware of the Clarion University Authorized Adult or Program Staff Code of Conduct and the expectation that it shall be followed (see below).

Supervision Ratio- for groups with minor participants or attendees, it is the program administrators responsibility to ensure the following supervision ratios must be met:

Standards for residential programs:

No minor under the age of 10 is allowed to participate unless accompanied by a parent or guardian.

One staff member for every 12 campers ages 10 to 17 Standards for day programs:

No minor under the age of 6 is allowed to participate unless accompanied by a parent or guardian.

One staff member for every 12 participants ages 6 to 17.

All events with minors present must follow the Clarion University Protection and Supervision of Minors on Campus policy including completing necessary paperwork, providing a list of authorized adults, clearances, mandated reporter training, etc. User is responsible for proper completion of paperwork through the Conference and Events office.

Program Administrators shall retain all records of program documents including but not limited to participant forms, clearances, trainings, mandated reporter training, etc. for no less than 25 years from the conclusion of the event.

The above listed requirements will be incorporated by reference as part of the formal agreement for use of facilities if this request is approved. Required signatures on the agreement will be designated at time of execution.

This Request for Use of University Facilities and Services must be returned by 15 WORKING DAYS PRIOR TO EVENT to Clarion University Office of Conference & Event Services. The Office agrees to hold the space listed in this agreement on a tentative basis until 15 DAYS PRIOR TO THE EVENT. If this request is not fully executed by the above date, the Office of Conference & Event Services will release the requested space.

The undersigned confirms that he/she has read the above terms and conditions for use of University facilities and acknowledges responsibility for complying with these requirements for the organization listed (see Item No. 1) if this request for use is approved by the university:

Clarion University Authorized Adults or Program Staff Code of Conduct

Authorized adults or program staff should be positive role models for minors and act in a responsible manner that is consistent with the mission of Clarion University. Authorized adults or program staff are required to comply with all applicable laws and PASSHE Board of Governors’ and Clarion University policies. Authorized adults or program staff working in programs covered by this policy must follow these expectations.

a. Do not engage in any sexual activity, make sexual comments, tell sexual jokes, or share sexually explicit material with minors or assist in any way to provide access to such material to minors.

b. Do not engage or allow minors to engage you in romantic or sexual conversations or related matters. Similarly, do not treat minors as confidantes; refrain from sharing sensitive personal information about yourself. Examples of sensitive personal information that should not be shared with minors are information about financial challenges, workplace challenges, drug or alcohol use, and romantic relationships.

c. Do not touch minors in a manner that a reasonable person could interpret as inappropriate. All personal contact should generally only be in the open, and in response to the minor’s needs, for a purpose that is consistent with the program’s mission and culture, or for a clear educational, developmental, or health-related purpose (e.g., treatment of an injury). Any refusal or resistance from the minor should be respected.

d. Do not use harassing language that would violate Board of Governors’ Policy 2009-03: Social Equity, or university harassment policies.

e. Do not be alone with a minor. If one-on-one contact is required, meet in open, well- illuminated spaces or rooms with windows observable by other authorized adults or program staff, unless the one-on-one contact is expressly authorized by the program administrator or is being undertaken for medical care.

f. Do not meet with minors outside of established times for program activities. Any exceptions require written parental authorization and must include more than one authorized adult or program staff.

g. Do not invite individual minors to your home or other private locations. Any exceptions require authorization by the program administrator and written authorization by a parent/guardian.

h. Do not provide gifts to minors or their families independent of items provided by the program.

i. Do not engage or communicate with minors except for an educational or programmatic purpose; the content of the communication must be consistent with the mission of the program and the university.

j. Do not engage in any abusive conduct of any kind toward, or in the presence of, a minor, including, but not limited to, verbal abuse, striking, hitting, punching, poking, spanking, or restraining. If restraint is necessary to protect a minor or other minors from harm, all incidents must be documented and disclosed to the program administrator and the minor’s parent/guardian.

k. Do not use, possess, or be under the influence of alcohol or illegal drugs while on duty, or in the presence of minors involved in a program, or when responsible for a minor’s welfare.

l. Do not provide alcohol or illegal substances to a minor.

m. Do not provide medication to a minor unless authorized by the program’s medication management guidelines.

n. When transporting minors, more than one authorized adult or program staff from the program must be present in the vehicle, except when multiple minors will be in the vehicle at all times through the transportation. Avoid using personal vehicles if possible and comply with the program’s transportation guidelines.

Violations of any of the forgoing shall be reported to the program administrator.

Last Updated 3/4/20