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Student Activity Accounting Important Items to Remember
1. Funds spent must be for the benefit of the students that raised them.
2. Always safeguard fundraising money in a locked facility.
3. We are required by law to give you a receipt when you deposit money.
4. Purchase orders are required for all purchases.
5. Activity account money can’t be spent on coaches wear or coaches meals where students are
not present.
6. You will receive monthly statements on your activity account.
7. Fundraising checks must be made out to the school, not parents or advisors.
8. Don't use cash to pay expenses.
9. The District and the students appreciate what you do.
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Student Activities Handbook Table of Contents
Philosophy ....................................................................................................................................................... 4
What Are Student Activity Funds? .................................................................................................................. 4
Who Can Answer My Questions About Student Activities And Student Activity Funds? ………………..…….. 4
General Information Regarding Student Activities ........................................................................................... 4
Where Do I Get Forms? ................................................................................................................................... 4
What Do I Need to Do to Hold a Meeting or to Reserve a Space? ................................................................... 4
Publicizing Student Organizations or Activities ................................................................................................. 5
Arranging Bus Transportation ........................................................................................................................... 5
Fieldtrips ............................................................................................................................................................ 5
Student Accidents During Club Sponsored Events ........................................................................................... 5
New Student Activity Approval Process ............................................................................................................ 6
Finance and Accounting for Student Activity Accounts .................................................................................. 6
General Information ........................................................................................................................................... 6
How Do I Find Out if There is Money in my Activity Account? ........................................................................... 7
Does My Club or Organization Get Money Budgeted From the School? .......................................................... 7
Fundraising Activities .......................................................................................................................................... 7
Cash Handling and Collection ............................................................................................................................ 8
Additional Information for Fundraising................................................................................................................. 8
Expenditures -What Can Student Activity Account Funds be Used For? .......................................................... 9
Examples of How Student Activity Funds May be Spent…................................................................................ 9
Examples of Student Activity Account Expenditures That Do Not Qualify As Allowable Expenditures ............ 10
Ethics ................................................................................................................................................................ 11
Expenditures-General ........................................................................................................................................ 11
Cash Disbursements (Paying a bill or RECIEVING a reimbursement) .................................................................. 12
Forms....................................................................................................................................................... Exhibits A-O
Building and Grounds Request & Agreement Form (exhibit A)
Fieldtrip/Overnight Trip/Bus Request Form (exhibit B)
School Trip Permission Form Single Trip (exhibit C)
School Trip Permission Form for Year (exhibit D)
School Trip Permission Form Overnight (exhibit E)
Student Accident Report (exhibit F)
Accident Claim Form (exhibit G)
New Club/Activity Proposal (exhibit H)
Fundraising Proposal Form (exhibit I)
Fundraising Reconciliation Form (exhibit J)
MCHS Activity Deposit & Expenditure Form (exhibit K)
Event Form (exhibit L)
Student Trip Budget Request Form (exhibit M)
Student Trip Budget Worksheet (exhibit N)
Conference/Athletic Clinic Expense Voucher (exhibit O)
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Philosophy
The Board of Education believes school
sponsored, school-supervised athletic and
extra-curricular activities provide students
with invaluable educational, as well as
instructional, skills and knowledge. The
District, in light of that philosophy, provides
the opportunity for students to join a wide
variety of clubs and organizations to enhance
their educational experience at Marengo.
Because of the large amount of student money
received from and expended for student
activities, the District requires accounting
procedures that provide efficient, thorough and
safe management of these funds. In this
handbook are the guidelines and sample forms
advisors and administrators should follow to
facilitate the proper administration, accounting
and safe handling of activity funds.
The Board recognizes that a student's
academic education must take precedence
over participation in such activities. Please
refer to the Extracurricular Code of Conduct
in the "Student Handbook" for student
participation.
Student activity account procedures are
regulated by the Board of Education Policy
7:325; Administrative Procedure 4:90AP;
Illinois Administrative Code, Subpart A,
Title 23, Part 125, and Illinois School Code
Section 10-20.19(3).
What are Student Activity
Funds?
Student activity funds are those funds, which
are owned, operated, and managed by
organizations, clubs, or associations (groups)
within the student body under the guidance
and direction of one or more faculty or staff
members for educational, recreational, or
cultural purposes.
Student Activity Funds are used to safeguard
and account for money raised by students and
expended for the benefit of those students.
Activity Funds are characterized by student
involvement with the direction and/or
supervision of adult advisors.
Who Can Answer My Questions
About Student Activities and
Student Activity Funds?
The Activities Director/Athletic Director
can answer most questions the advisor may
have regarding the policies and procedures
for fundraising, fund expenditures,
building use, student participation,
transportation and insurance. The District
Office can answer questions about fund
receipts, fund disbursements, records of an
account's transactions and account
balances.
General Information Regarding Student Activities
Where Do I Get Forms?
There are several ways to obtain forms. The
District Office has a supply of forms located
on the counter in the District Office. Printable
copies of each form are located on the MCHS
website at www.mchs154.org
(Documents/Staff Forms/Business Office).
What Do I Need to Do to Hold a
Meeting or to Reserve a Space?
Complete a Building and Grounds Request &
Agreement Form (exhibit A). This form must
be completed and approved by the Activities
Director/Athletic Director at least five
business days in advance of the meeting. One
form can be used for multiple meetings. This
will reserve your space, schedule any set-up
that is required, alert security, and make sure
the meeting is listed on the master calendar.
This form may be obtained from
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Transportation Office or on the MCHS
website at www.mchs154.org
(Documents/Staff Forms/Building &
Technology).
Following an activity or event, all student
groups must restore the meeting room to its
original state so that the room is ready for the
next day of classroom use. The District
provides routine custodial service.
Publicizing Student Organizations or Activities
Publicizing an event internally to the students
and faculty can be accomplished through
several different methods. A limited number of
posters may be hung in designated locations in
the building. Please forward the original poster
to the Principal for approval. In addition,
events can be included in our daily
announcement. Please notify the secretary in
the Administration Office by 7:30am to
include information on your activity in the
announcements. The information will run in
the bulletin for one day, unless other
arrangements are made.
For external publications to the media, please
contact the Superintendent's Secretary.
Arranging Bus Transportation
Marengo’s Transportation Department will
provide bus transportation to activities. A
Fieldtrip/Overnight Trip/Bus Request Form
(exhibit B) must be completed and turned in.
The use of outside bus services must be
approved in advance. Please see the Director
of Transportation for further information.
The School Board Policy Manual states that
no school employee may transport students
in school or private vehicles unless
authorized by the administration. The use of
rental cars or other modes of transportation
must also be authorized by the
administration.
Any student transported by Marengo
Community High School must be transported
from the place of origin to the destination, and
returned back to the place of origin, or other
agreed on place. If a parent or guardian wishes
to pick up a student at any time other than at
the completion of the trip, the parent or
guardian must have the written permission of
the advisor.
Fieldtrips
A Fieldtrip/Overnight Trip/Bus Request Form
must be turned into the Principal to receive
approval for any fieldtrip. Once approved, the
form will be forward to the transportation
department to schedule the busing. Also, a
School Trip Permission Form for a Single Trip
(exhibit C) or a School Trip Permission Form
for the Year (exhibit D) or a School Trip
Permission Form for an Overnight Trip
(exhibit E) must be signed by the
parent/guardian and returned to the advisor
before the student is allowed to attend any
fieldtrip. The advisor will keep these forms on
file.
Student Accidents During Club
Sponsored Events
Should a student accident or emergency
incident occur during a school-sponsored
event or activity, the advisor, coach or athletic
trainer should complete and send a Student
Accident Report (exhibit F) to the Principal,
Activities Director/Athletic Director, Student
Services secretary, and school nurse. If a
doctor is seen, the Student Services secretary
will then complete an Accident Claim Form
(exhibit G). Copies of the Accident Claim
form should be stapled to the Student Accident
Report and forwarded to the injured student's
parent/guardian.
If a student is injured during a school-
sponsored event or activity, the advisor should
instruct the injured student, as well as the
parent/guardian to obtain a copy of the
completed Accident Report from the Student
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Services secretary in order to submit an
insurance claim.
Marengo Community High School District
154 is enrolled in a student accident insurance
program for student accidents that occur on
school property or during a school-sponsored,
school supervised event. This policy is
secondary insurance coverage. The
parent/guardians' insurance is the primary
carrier. Important notice: This plan of
insurance is secondary to other health
insurance coverage. A student's
parent/guardian should be instructed to
submit claims to their primary insurance
company first. When they receive an
Explanation of Benefits Statement, they
should send it along with an itemized bill
and the completed student accident
insurance form to the address on the Student
Accident Claim Form. Payment will be
made to the providers of service (hospital,
physician, or others), unless a paid receipt
statement accompanies the bill at the time
the claim is submitted. Student and
parent/guardian should be instructed to
communicate directly with the student
insurance carrier regarding any insurance
matters.
New Student Activity Approval
Process
In order to establish a new club,
organization or group, a New Club/Activity
Proposal Form (exhibit H) must be
completed and given to the Activities
Director/Athletic Director and the Principal.
The Board of Education and/or the
Superintendent must approve all new
activities. No meetings can be conducted nor
can money be collected until an activity
receives proper approval. All activities must
have a faculty advisor present at all
meetings.
Finance and Accounting for Student Activity Accounts
General Information
1. No activity should maintain cash on
hand without prior permission.
Organizations may not maintain
their own accounts at a local bank.
2. No payment for expenses of the
activity should be made directly
from the cash or receipts of the
activity. Expenses must be paid by
check from MCHS with proper
detailed substantiation.
3. All clubs and organizations must be
financially self-supporting and will
only draw money from their
accounts when there is a sufficient
balance.
4. All money-making activities must
be approved by the Principal
through a Fundraising Proposal
Form (exhibit I). Dues, if assessed,
must be approved by the Principal.
5. A financial record of all transactions
is maintained for each activity by
the District Office. Activities are
encouraged to maintain their own
records and use the statements from
the District Office as an internal
check. Advisors will receive a copy
of the monthly activity report for
their account. It is the advisor's
responsibility to review the report
and verify that their account is
correct. Any errors should be
communicated to the District Office
for reconciliation.
6. The Activities Director will, on an
annual basis, review with the
advisor the group's plan or budget
and purpose for the upcoming year.
This assists the District Office to
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properly account for receipts and
approve expenditures. The
Fundraising Proposal Form also
provides additional plan or budget
information, which is used by the
District Office as a guideline for
properly accounting for receipts and
approving expenditures.
How Do I Find Out if There is
Money in my Activity Account?
The District Office will, on a monthly
basis, send a statement to the advisor
detailing the fund balance and transactions
in their activity account. Contact the
District Office if a current statement is
needed.
Does My Club or Organization Get Money Budgeted From the School?
Only clubs or organizations that engage in
interscholastic competition are funded by
the District. All other clubs and activities are
selfsupporting.
Fundraising Activities
1. The Principal exercises general
control over all fundraising
activities and must approve all
activities that affect the student
body.
2. Once a group decides to fundraise, it
is the advisor's responsibility to
complete a Fundraising Proposal
Form and to obtain prior approval
for the fundraising activity from the
Principal. This form outlines your
group's plan and budget for the
funds to be raised and spent.
3. Fundraising may be conducted in
school before and after school hours
and during. Any fundraising that
takes place during a lunch period
will require the supervision of a
sponsor or other designated adult
supervisor at all times. Cafeteria
supervisors are not to be supervising
fundraisers. No fundraising may be
conducted during class time.
4. Students must be notified of the
purpose of the fundraiser, and what
the funds will be used for.
5. No fundraising may be conducted
by non-school sponsored groups
except those which are of a school-
wide nature in which participation
can be a positive experience for
students and when the proceeds
contribute to a recognized
humanitarian purpose.
6. All fundraisers must be reconciled.
Included in this handbook is a
Fundraising Reconciliation Form
(exhibit J) that should be used by
the advisor. The District Office will
assist you with this process.
7. Student fundraising is to be on a
voluntary basis only. No student is
to be pressured to do any type of
fundraising, whether by staff or
students. Any violation may be
subject to disciplinary action.
8. Any student group or adult support
group that intends to solicit gifts,
donations, or subsidies from
businesses or foundations outside of
the school must have prior
authorization from the Principal and
the Activities Director/Athletic
Director, for such solicitation.
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Cash Handling and Collection
Advisor Collection
1. The activity advisor is responsible
for the collection and safe handling
of funds received on behalf of their
group. They are also responsible for
the supervision of students having
contact with cash or checks.
2. All checks collected shall be made
payable to Marengo Community
High School or MCHS.
3. Funds must be counted by the
advisor. Either a Fundraising
Reconciliation Form or a MCHS
Activity Deposit & Expenditure
Form (exhibit K) is to be completely
filled out, including the total amount
of the deposit, and signed by the
advisor. Write the name of the
activity and fundraiser on the
Activity Deposit form. Any
spreadsheets or listings of student’s
payments related to the deposit
should be included with the
Reconciliation or Activity Deposit
form. The spreadsheet should
contain the student's name, check
number, or if cash is submitted,
write the students name with “cash”
behind the name and the amount.
Submit form and funds to the
District Office.
4. The preferred method of deposit is
depositing funds with the District
Office who will log in your deposit,
verify the funds with a second
count, sign off on the Activity
Deposit form, place your funds in a
locked safe and will deposit the
funds in the bank. The District
Office will place a copy of the
Activity Deposit form in the
advisor’s mailbox. Do not leave
funds unattended. Should the
Payroll Administrator be
unavailable, the deposit should be
given to another individual in the
District Office.
5. Advisors should deposit all cash and
checks daily. Money that is
collected during evening and
weekend activities should be locked
up at the school in a safe and should
not be removed from the school
building. Money shall not be taken
home, left in drawers or out in the
open. Please seek out a building
representative to lock your deposit
in the safe.
Additional Information for Fundraising
1. All events that require an admission
fee shall sell tickets. Tickets for all
events shall be sequentially
numbered. Beginning ticket number
and ending ticket number should be
entered on the Event Form (exhibit
L) that is put in the cash box. Ticket
sellers shall account for all tickets
received by returning a dollar
amount that is equal to tickets sold
multiplied by the admission charge
per participant. At the end of ticket
sales, the collectors shall go to a
private location to count the money
and fill out the Event Form. The
Activities Director/Athletic Director
can assist with obtaining pre-
numbered tickets.
2. All printed tickets should be
reconciled to cash and checks
received using the Event Form. The
cash box should be locked in a safe
when the event is over and the
money is counted. The Event Form
will be submitted with the money to
verify the deposit amount.
3. All club advisors should reconcile
all fundraisers including sales of
merchandise using the Fundraising
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Reconciliation Form or other
acceptable reconciliation summary.
This should be forwarded to the
District Office. Remaining inventory
of merchandise to be sold at a later
date should be maintained and
tracked.
4. The District Office will issue a
receipt for monies deposited. A
copy of the receipt will be given to
the activity advisor and should be
kept in the organization's files. A
copy will be on file with the District
Office. Advisors should check
immediately that the information on
the receipt received agrees with the
amount deposited.
5. The District Office will assist you in
counting deposits for large events.
Expenditures - What Can Student Activity Account Funds Be Used For?
The purpose of raising and expending
student activity funds is to promote the
general welfare, education, and morale of
all the students and to finance approved
extracurricular and co-curricular activities
of student body organizations.
Student activity money should be expended
in such a way as to benefit the students who
have contributed to the accumulation of such
money. Money collected by a student body
as a whole shall be expended so as to benefit
the student body as a whole and not for the
benefit of a special group.
Money raised in a specific academic year
should generally be spent in the same year.
We recognize in limited situations, a group
may raise funds over more than one
academic year for a specific purpose. An
example of this situation would be a "class
account" saving for prom or a class gift.
Examples of How Student Activity Funds May be Spent
Expenditures for Student Activity Accounts
must be clearly identified as to the purpose
for the expenditure on the MCHS Activity
Deposit & Expenditure Form. The following
are some examples of allowable
expenditures:
• Fundraising expenses that are clearly
identified as a fundraising expense
(i.e. supplies, fees, materials, advertising,
etc.).
• Supplies that are clearly identified as the
student club or organization's operational
expenses. The purpose of the expenditure
must be clearly identified.
• Any purchases for uniforms, team apparel,
etc., can only be given to the student
participants, student helpers for that team,
coaches, volunteer coaches and other people
involved in that team. It cannot be
distributed as gifts to others outside of team
involvement (example: t-shirts, hats, sports
bags, etc.).
• Food and beverages may be provided when
the organization holds a meeting or is
conducting the activities of the group. These
expenditures should be limited in use to
awards, recognitions or times when such
meetings cause an unreasonable amount of
time between normally scheduled meal
times.
• Publications such as magazines, books,
and periodicals when such publications will
be used for the benefit of the student
organization involved.
• A gift to the school, either monetary or
otherwise, with the approval of the Activity
Advisor, Activities Director/Athletic
Director and Superintendent. If the gift is
monetary and non-designated, it may be
spent by the Board of Education in a manner
that is in the best interest of the student
body.
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• Coach or Advisor uniforms and apparel
specific to the student organization and used
to assist in the identification of the coach or
advisor if they are reasonable in nature.
• Conference and related meal costs that are
required attendance for an advisor or student
member representative. Please note the
2012-13 established rates for District
reimbursement of travel daily meal
allotment for students participating in state
level tournaments is $30.00 per day (Board
Policy). The reimbursement for students is
$8.00 for breakfast (if hotel provides
breakfast, breakfast is not reimbursable);
$12.00 for lunch; and $15.00 for dinner.
When planning a trip with students, before
leaving the Student Trip Budget Request
Form (exhibit M) must be filled out and
submit to the District Office. The Student
Budget Worksheet (Exhibit N) can be found
at www.mchs154.org (Documents/Staff
Forms/Business Office/ Student Trip Budget
Worksheet – save worksheet to your
computer). Complete the form and attached
to the request form. Staff amounts are $40
per day broken down as $10.00 for breakfast
(if hotel provides breakfast, breakfast is not
reimbursable), $15.00 for lunch and $15.00
for dinner. When being reimbursed for
meals, fill out the Conference/Athletic
Clinic Expense Voucher (exhibit O) and
submit to the District Office along with the
receipts.
• These same amounts will be the maximum
allowable amounts of any approved
reimbursements from student activity
accounts. Itemized meal receipts must be
attached to any requests for reimbursement.
At no time will there be reimbursement for
alcoholic beverages or tobacco products.
Mileage will be reimbursed as allowable by
the Internal Revenue Service. Detailed
receipts must be provided. Please detail on
the receipt the attendees and purpose of the
meal.
• Conference and related hotel or motel costs
that are required attendance for an advisor or
student member representative. Hotel costs
will be limited to comparable hotels or
motels in the area. However, if the
conference is being held in a hotel or motel,
the advisor may choose to stay at that hotel
or motel. An itemized bill must accompany
any requests for reimbursement.
• Reimbursements relating to the student
club or organizational fees, dues, and
memberships.
• A gift to a charitable organization if
approved by the student members.
• Meals for staff volunteers when that
volunteer is a professional volunteering for
the majority of the day. The meal must be at
a reasonable cost, and is considered a
reasonable accommodation for the
volunteer's services.
• Meals for other volunteers will not be
disallowed if meals are also provided to the
student participants.
• A transfer between student activity
accounts can only be done with the written
approval of the both advisors of the two
student activity accounts.
• Only nominal prizes or awards are
allowed.
Examples of Student Activity Account Expenditures That Do Not Qualify As Allowable Expenditures
• Prepaid expenses without proper detailed
documentation.
• Loans or credits to employees or other
persons.
• Gifts to coaches or advisors paid from the
activity account.
• Uniforms that are not specific to the
student organization or that are not used to
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assist in the identification of the coach or
advisor.
• Payments for expenditures not benefiting
the students in the club or organization.
• Meals and refreshments for coach's
meetings.
Ethics
Advisors and coaches are asked to use their
best judgment and common sense when
incurring or approving expenditures. All
staff must make sure the expenditures are
reasonable, the activity honestly incurred,
are ethically responsible and do not result
in personal benefit to the staff member.
It is the District's practice to prohibit
purchasing items for District use from
District employees or their immediate
family members (spouse and/or minor
children).
Board policy prohibits the employment of
relatives or members of the same households
in situations where one supervises another.
Hiring other individuals that may be
perceived as a conflict of interest should
also be avoided.
Expenditures-General
1. Each activity must include in the
Fundraising Proposal Form an
estimate of expenses prior to
making commitments for those
expenditures. This approved form
serves as the guideline for the
District Office to determine the
reasonableness and appropriateness
of expenditures before payment to
the vendor is made.
2. The District Office discourages
advisors from paying for items
themselves then asking for
reimbursement from the District
Office at a later date. We do
recognize that these situations arise
but they should be the exception
rather than the frequent procedure.
3. All cash receipts from a fundraising
event should be deposited in full
before advisors submit a written
request to disburse student activity
funds.
4. An activity will not be charged for
use of the building, security or
custodial services.
5. All contracts about to be entered
into on behalf of Marengo
Community High School 154 will
be submitted to the District Office
for approval.
6. Any purchases greater than or equal
to $25,000 will be subject to the
public bidding requirements of the
Illinois School Code. Please contact
the District Office with questions
regarding bidding a purchase.
7. The District Office must receive
cash advance or check requests no
later than 5 business days before
needed. All receipts and remaining
funds must be returned to the
District Office within 2 business
days after the end of the event.
8. If an account of a school-sponsored
activity or club has a cash balance
remaining after a two-year period
during which there is no activity in
the account or if the activity or club
ceases to exist, this balance may be
transferred to another student
activity account, or expended as the
Board of Education determines in
accordance with the Illinois
Administrative Code.
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9. Any apparel ordered must be
maroon, white, gray or black.
School Administration must
approve any other color in advance.
Cash Disbursements (Paying a bill or getting a reimbursement)
1. In all situations, an advisor must
request a purchase order number
from the Business Manager in
the District Office. Once the
District Office approves a
request, an order is placed with
a vendor. This purchase order
allows us to place the order,
paying for the goods at a later
date. The District Office
generally will fax the purchase
order to the vendor unless prior
arrangements have been made
with the advisor. Most vendors
will accept a purchase order
from the school district. This is
the required method to order
goods and services. Notify the
Business Manager in the District
Office to set up new vendors.
Include the name, address,
phone number and fax number
and Tax ID# of the vendor.
2. After the ordered goods have
been received, forward the
signed packing slip with the
Purchase Order notated along
with documentation to the
Business Manager in the District
Office. Please keep copies for
your records.
3. If you are requesting a
reimbursement, please complete
an MCHS Activity Deposit &
Expenditure Form. This form
should be completely filled out
and forwarded to the Business
Manager for proper approval.
No payments will be made
unless all supporting
documentation is attached.
Original invoices and receipts
must be attached. Please keep
copies for your records.
4. Disbursement requests may be
submitted at any time; however,
the District Office will write
checks once a month. Student
Activity Funds should,
whenever possible, be spent for
the benefit of those students
currently in school who have
contributed to the accumulation
of such funds.
5. Allow sufficient time for
requests for payments to be
reviewed and processed. We
understand that emergencies
may occasionally occur and one
may need a check processed
immediately. Try to avoid "last
minute" transactions as much as
possible.
6. There is 60-day limit on checks
issued. Stop payments will be
made on checks not cashed
within this time period.
Exhibit A
COPY TO: District Office, Administrative Office, Student Services, Athletic Director, Head Custodian,
Principal, Assistant Principal (Master Calendar), Transportation Secretary, Party of the Second Part, Others listed
BUILDING AND GROUNDS REQUEST & AGREEMENT FORM Date (s) requested ____________________________Admission Charged: Yes ______No______
Time (s) requested (From –To) ex: 7PM-10:30PM
Building Access M_______Tu_______W_______Th_______Fr_______Sat_______Sun_______
Activity Time M_______Tu_______W_______Th_______Fr_______Sat_______Sun_______
Full Name of Organization ________________________________________________________
Mailing Address ________________________________________________________________
Representative ___________________________ Telephone __________________________
Attendant Responsible _____________________ Telephone __________________________
Certificate of Insurance required: Yes____No____Fee Class of Organization (circle) A B C
District Staff Required: Yes_____No_____See below
FACILITY (Check) EQUIPMENT (Check)
______ Gymnasium ______ Podium
______Classroom (s) ______# of Rooms ______ # of Chairs
______Kitchen ______ # of Tables
______Dining Area ______ Public Address System
______Auditorium ______ Lighting Equipment
______Computer Lab ______ Press Box
______Commons Area ______ Lights
______Balcony ______ Water
______Fitness Room ______ Waste Removal
______Concession* ( Outdoor Indoor )
______Athletic Field (Baseball– Softball – Soccer – Tennis – Track –Football
Charges: Facility (s) $___________
Personnel ___________
Other Costs ___________ For_______________________________________
Deposit ___________
Total $ ___________
*MUST HAVE A HEALTH DEPARTMENT PERMIT & CERTIFIED FOOD MANAGER ON SITE
School rep. verification
of facility availability ___________________________ Date ________________________
Renter Representative ___________________________ Date _________________________
Use Approved ______ Disapproved ______
Superintendent ____________________________ Date ______________________________
That Marengo Community High School District #154 (hereafter referred to as “Party of the First Part”)
does lease its environs to the ___________________________________(hereafter referred to as “Party of
the Second Part”) for approximate dates listed below, and that the Party of the Second Part shall pay the
Party of the First Part (School) $ for the lease and use of said property.
The person, organization, group, team, agency or business requesting use of the facility will be referred to
as the “Contractor” and shall indemnify, keep and save harmless the Board, its agents, officials and
Exhibit A
COPY TO: District Office, Administrative Office, Student Services, Athletic Director, Head Custodian,
Principal, Assistant Principal (Master Calendar), Transportation Secretary, Party of the Second Part, Others listed
employees, against all injuries, deaths, losses, damages, claims, patent infringements or copyright
infringement claims, suits, liabilities, judgments, costs and expenses, which may in any way accrue against
the Board in consequence of the granting of this contract, or which may in any way result there from,
whether or not it shall be alleged or determined that the act was caused through negligence or omission of
the Contractor or his employees, or of any of the subcontractors or his employees, and the Contractor shall,
at his own expense, appear, defend and pay all charges of attorneys and all costs and other expenses arising
there from or incurred in connection therewith, and, if any judgment shall be rendered against the Board in
any such action, the Contractor shall, at his own expense, satisfy and discharge the same. The Contractor
expressly understands and agrees that any insurance protection required shall in no way limit the
responsibility to indemnify, keep and save harmless and defend the Board as herein provided.
The School shall coordinate its schedule with the other lessees.
The Party of the Second Part understands that in all situations that Marengo Community High School
Programs will take precedent over any prior agreement. This simply means that the Party of the Second
Part may have to surrender said facility for high school programs due to extenuating circumstances.
Before and after facilities are utilized, an inspection of the requested area(s) will be made. All non-school
related groups must agree to pay any damages to school facilities, furniture, or equipment arising out of its
use, whether such damage was accidental or deliberate. The cost of damages will be based on the repair or
replacement cost, the choice of which is at the Board’s discretion.
All non-school related groups must agree to use appropriate emergency procedures including call 9-1-1 for
medical emergencies and whenever an AED is used.
All non-school related groups must agree to follow the District’s Plan for Responding to a Medical
Emergency at an Indoor Physical Fitness Facility, 4:170-AP6. Important: the District will not supervise
the activity nor will it supply individuals to act as emergency responders.
___ Activity being proposed is not in an indoor physical fitness facility.
If the request involves an indoor physical fitness facility, the non-school related group must:
Designate at least one adult who agrees to be an emergency responder. If possible, all emergency
responders should be trained CPR and AED users.
Give a copy of the District’s plan for responding to medical emergencies to each designated
emergency responder.
Require that 9-1-1 be called for medical emergencies and whenever an AED is used.
Ensure that each designated emergency responder knows the location of first aid equipment and
any AED.
Ensure that only trained AED users operate an AED, unless the circumstances do not allow time
for a trained AED user to arrive.
Arrange for a least one emergency responder to have a tour of the facility before the activity.
Ensure that if an AED is used, all appropriate forms are completed (4:170-E6), Automatic
External Defibrillator Incident Report).
I agree to abide by the conditions stated in this application and agree to adhere to all Board policies and
administrative procedures.
_________________________________________ ______________________
Signature of The Party of the Second Part Date
Received Payment of $________________ Cash________ Check________
Received Deposit of $________________ Cash________ Check________
*NOTE: PAYMENT/DEPOSIT MUST BE MADE WITH THE REQUEST
Facility Use Agreement – Revised 8-1-2011
Exhibit B
FIELD TRIP / OVERNIGHT TRIP / BUS REQUEST FORM - MCHS STAFF
Field Trip Date(s) _____/_____/_____ - _____/_____/_____
Overnight Trip: _____Yes _____No
Location of Trip: City ____________________________________________________
Facility – Area To Be Visited _______________________________________________
Class / Group-Attending Trip: _______________________________________________
Approximate Number of Students: ___________________________________________
Arrangement for Meals, Meal Costs, and Fees, etc. (explain) ________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Chaperones Needed: _______ Bus Requested: _______ Car Requested __________
Round Trip Mileage: _______ Leave Time: __________ Return Time __________
Sub Needed: ___________ If yes, for what class periods:___________________________________
If other teachers are also going, please list names and what periods they will need subs:
_________________________________________________________________________________
_________________________________________________________________________________
State the Educational Value of the Trip and Describe Student Activity:
Teacher Signature:____________________________
_____ Trip and date Approved for ____/____/____
_____ Trip and Date Not Approved for the Following Reason(s):
___ Two trips already scheduled for the week requested
___ Date conflicts with activity on master schedule.
___ Educational value of trip is not acceptable.
___ Other
Principal: __________________________________ ____/____/____
Copies to: Transportation, Teacher, District Office
Exhibit C
SCHOOL TRIP
PARENT PERMISSION FORM
SINGLE TRIP
MCHS encourages participation in field trips and extra-activity trips. Every effort will be taken to
safeguard the students. However, in the event of an accident or emergency we will need to contact the
parents.
This form must be completed, signed and returned to the sponsor or coach in order for the
student to participate.
The ________________________________ will travel to _________________________
(group) (destination)
on ____/____/____ by ________________________. They will leave school at _______
and return at approximately______________.
I give my permission for ___________________________________________________
(student name)
to participate.
________________________________ _________________
Signature of parent / guardian Phone number
____/____/____
Date
PLEASE RETURN THIS FORM TO YOUR SUPERVISOR/SPONSOR/COACH.
Exhibit D
SCHOOL TRIP
PARENT PERMISSION FORM
FOR YEAR
MCHS encourages participation in field trips and extra-activity trips. Every effort will be taken to
safeguard the students. However, in the event of an accident or emergency we will need to contact the
parents.
This form must be completed, signed and returned to the sponsor or coach in order for the
student to participate.
______________________________________ has my permission to participate in trips
(student name)
which the _______________________________________________________________
(group)
will take at various times during the school year.
________________________________ _____________________
Signature of parent / guardian Phone number
____/____/____
Date
PLEASE RETURN THIS FORM TO YOUR SUPERVISOR/SPONSOR/COACH.
Exhibit E
SCHOOL TRIP
PARENT PERMISSION FORM
OVERNIGHT
This form shall be used for all overnight trips approved by the Board of Education,
District # 154.
Suggestion: The sponsor/supervisor/coach should fill in the required information on one
form, and then have additional form run off for student use.
Each student will be required to stay with and remain a part of his/her group. No student
will be permitted to be left on their own at any time without supervision.
A display of appropriate respect for others and regard for property, materials, and
equipment must be shown throughout the trip.
Students are to know and abide by all school rules as stipulate in the MCHS Student
Handbook on Conduct, Discipline, and Attendance. These rules will apply to all students
from the time buses leave school and return from all scheduled bus runs and to include
MCHS referenced on page “B” of the MCHS Student Handbook for Conduct, Discipline,
and Attendance.
Students violating civil law will be turned over to local authorities and dealt with by
them. Patents will be notified by phone and shall be responsible for their son/daughter
thereafter.
The _______________________________ will travel to __________________________
(group) (destination)
on ____/____/____ in (vehicle) ___________________________. The student will be
staying at the ____________________________________________________________
(name, address, phone # for motel/ lodging, ect.)
Leave school ________________________.
Return to school _____________________.
I give my permission as parent/guardian for_____________________________________
To participate in this overnight field trip. I understand that my son/daughter will be
responsible for his/her expenses. Amount $_____________________.
__________________________________ _______________________ ___/___/___.
PLEASE RETURN THIS FORM TO YOUR SUPERVISOR/SPONSOR/COACH.
Exhibit F
Copies to: Principal, Student Services secretary, school nurse
STUDENT ACCIDENT REPORT
MARENGO COMMUNITY HIGH SCHOOL
Date Submitted _______/_______/_______ Date of Accident _____/______/______ Time _______ am/pm
Student Involved Report Filed By ______________________________________
Name______________________________ Position ___________________________________________
Grade _______ Age _______ Sex______ This Accident Occurred Under the Direct Supervision Of
Class Class Period ______________ Print Name ________________________________________
Class ______________________________ Sign Name __________________________________________
Part of Body Injured: ___ Abdomen ___ Elbow R or L ___ Hand R or L ___ Shoulder R or L
___ Ankle R or L ___ Eye R or L ___ Head ___ Teeth
___ Arm R or L ___ Face ___ Knee R or L ___ Wrist R or L
___ Back ___ Finger ___ Leg R or L ___ Other ___________________
___ Chest ___ Foot R or L ___ Neck ___ Other ___________________
Location of Accident: Immediate Action Taken: ___ Athletic Field ___ Shop ___ First Aid by _____________________________
___ Auditorium ___ Stairs/Steps ___ Sent Home By ___________________________
___ Cafeteria ___ Transportation ___ Sent to Dr. By ___________________________
___ Classroom ___ Walkway/Outdoors Dr. Name __________________________________
___ Gym ___ Other ___ Sent to Hospital By _______________ _______
___ Hallway Hospital Name ______________________________
Activity Involved in Accident: Person Notified: ___ Athletics ___ Shop _____ Parent _____ Guardian
___ Classroom ___ Transportation Name of Person Notified _____________________
___ Free Time ___ Trip By Whom Notified ___________________________
___ Lunch ___ Other ByWhat Means ______________________________
___ Physical Ed. How Long After Injury _______________________
Apparent Nature if Injury: Witness to Accident: ___ Abrasion ___ Poisoning Name _____________________________ Staff ___
___ Bruise/Bump ___ Puncture
___ Burn ___ Shock (Electrical)
___ Cut ___ Sprain Name _____________________________ Staff ___
___ Dislocation ___ Sting Student ___
___ Fracture ___ Other _____________ First Staff Person at Scene of Accident
___ Head Injury
___________________________________________
Description of Accident: How and What Happened
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Principal’s Signature ________________________________________ Date__________________________________
Exhibit H
Copies to: Assistant Principal, District Office, Sponsor
CREATING A NEW CLUB
Any teacher or student having an interest in starting a new club may obtain a Proposal Form (see following pages) in the Student Activities/Athletic Director (AD) Office. After the completed form has been returned to the Student Activities/AD Office, the application goes through the following process: 1. Review of application by the Student Activities Director/AD and the Principal in light of the above criteria for school-
sponsored clubs and conditions for school-recognized club. 2. Meeting with potential sponsor and/or students and the Student Activities Director/AD and the Principal. 3. Written recommendation by the Student Activities Director/AD and the Principal to the School Board for acceptance or
rejection of the club as a school-sponsored club or school-recognized club. 4. Final written decision by the School Board. 5. If a club is accepted as a school-sponsored club, the club will be on "pilot" status for two full semesters and a specific plan
to start as a school-sponsored pilot club will be developed by the sponsor, students, and Student Activities Director/AD.
SUCCESSFUL COMPLETION OF PILOT STATUS A group initially approved as a pilot club may be approved for full status as a school-sponsored club upon application to the Student Activities Director/AD demonstrating that it has: 1. Been in existence at least one school year (two consecutive semesters); 2. Maintains a membership of at least 10 students; 3. Has a constitution describing the purpose, goals, and structure of the club; 4. Has identified activities; 5. Has an identified meeting structure; and 6. Has a District-paid adult sponsor.
NEW CLUB CRITERIA School-sponsored Clubs To be eligible for consideration as a club sponsored by Marengo High School, a club must meet the following criteria: 1. Evidence of sufficient student interest (i.e., 10 or more students); 2. Congruence with Board Policy and the District's purpose statement for its co-curricular program; 3. Availability of an appropriate adult sponsor; 4. Inclusiveness (i.e., the degree to which the club is designed to appeal to and include students regardless of race, sex, religion, national origin, disability, etc.); and 5. No significant duplication of purpose, goals, or activities of an existing school-sponsored club.
School-recognized Clubs Student clubs which Marengo High School determines not to sponsor may nonetheless be recognized by the school, in accordance with the federal Equal Access Act, consistent with the District's efforts to encourage the emotional, cultural, mental, physical, and social growth of its students, and subject to the following conditions: 1. Meetings or activities are voluntary and student-initiated; 2. There is no sponsorship of meetings or activities by Marengo High School, the government, or its agents or employees; 3. Meetings or activities do not materially and substantially interfere with the orderly conduct of educational activities within the school, nor are they unlawful or otherwise contrary to the mission of the school; 4. Employees or agents of Marengo High School or the government are present at religious meetings or activities only in a non-participatory capacity; 5. Non-school persons may not direct, conduct, control, or regularly attend meetings or activities; 6. Meetings and activities must occur during non-instructional time; 7. Marengo High School expends no funds beyond the incidental cost associated with providing the space for student initiated
meetings; and 8. All literature, signs, or other publicity of school-recognized clubs shall include a disclaimer provided by the District stating that
the club is not school-sponsored or endorsed, and must be approved by the Student Activities Director/AD or his/her designee before posting or broadcasting.
Exhibit H
Copies to: Assistant Principal, District Office, Sponsor
NEW CLUB/ACTIVITY PROPOSAL
The following form must be filled out in order to start a new club or activity. The completed form should be presented to the Student Activities Director/AD and the Principal .A meeting will follow to discuss the proposal. PERSON PRESENTING THE PROPOSAL: Name Email Address Phone #: NAME OF PROPOSED CLUB/ACTIVITY:________________________________________________________________ GENERAL DESCRIPTION OF PURPOSE OF PROPOSED CLUB/ACTIVITY: _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ GOAL(S) OF PROPOSED CLUB/ACTIVITY: 1. _______________________________________________________________________________________________ 2._______________________________________________________________________________________________ 3._______________________________________________________________________________________________ LIST AT LEAST FOUR ACTIVITIES OR EVENTS STUDENTS WILL PARTICIPATE IN: 1. ______________________________ . 3. ______________________________ 2. ______________________________ 4. ______________________________ What type of area do the students need to meet in (classroom, Gym, Commons, etc.) ________________________________________________________________________________________________ When and how often do you intend to meet? ________________________________________________________________________________________________ Have you contacted a sponsor? __________ YES __________ No Name of Proposed Sponsor: _________________________________________________________________________ What will it cost to operate the proposed club/activity? Describe where and how the money will be used. ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ Why do you think there is an interest in this proposed club or activity? ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ RETURN TO STUDENT ACTIVITIES DIRECTOR/ATHLETIC DIRECTOR * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * PROCESS Step #1 _____ Application is filled out and submitted to Student Activities Director/AD for review Step #2 _____ Meeting with Student Activities Director/AD and the Principal; potential sponsor, and/or students proposing new club
Step #3 _____ Written recommendation by Student Activities Director/AD and the Principal to School Board to approve or not approve as pilot club Step #4 _____ Final written decision by School Board _____ Approved as a pilot for the __________________ school year
Activities Director/AD ___________________________ Date: ____________________ Principal __________________________________ Date: ____________________
_____ Not Approved as a pilot for the _______________ school year Activities Director/AD ___________________________ Date: ____________________ Principal __________________________________ Date: ____________________
Exhibit I
Copies to: Assistant Principal, District Office, Sponsor
Fundraising Proposal Form Marengo Community High School
_______________________ _____________________ Club/Activity Type of Fundraiser
_______________________________________ ____________________________________
Advisor Name(s) Dates of Fundraiser
Item(s) to be sold:___________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
How much do you expect to raise? _____________________________________________________________
How will the proceeds be used? ________________________________________________________________
How many students will be involved? ___________________________________________________________
Vendor:___________________________________________________________________________________
Please list the type and estimated amount of expenditures: ___________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
________________________________________________
Advisor’s Signature Date
******************************************************************************************
Approved _______ Denied ________ __________________________________________________
Signature of Principal
Exhibit J
Fundraising Reconciliation Form Marengo Community High School
Club Name___________________ Fundraising Event _______________________ Date(s) of Sale ___________
Description of Items
Number of
Items for Sale Cost per Item Talley of Items Sold
Final Number
of Items Sold
Gross Sales per
Item
Advisor’s Signature/Date ___________________________________ Total Sales for this Activity _________________
This report must be completed in full for each fundraising activity and turned in to the District Office with the daily cash deposit.
Exhibit K
This form must be completed in full for each fundraising activity and turned in to the
District Office with the daily cash deposit.
MCHS ACTIVITY DEPOSIT & EXPENDITURE FORM
Requested by: Date: ________________ _________________________ Receipt # _________________________ Request for: Expenditure Deposit
Deposit or Purchase List Amount
PLEASE ENTER TOTAL AMOUNT
ACCOUNT # __________________________________ ________________ Signature of Advisor Date __________________________________ ________________ Signature of Bookkeeper/Treasurer Date
Exhibit L
Starting Adult Ticket #___________ Starting Student Ticket #___________
Ending Adult Ticket # ___________ Ending Student Ticket #____________
Event: ______________________________
STARTING CASH $ _______________ *Please verify and initial ______________
*ENDING CASH $ _______________ Deposit Total (for Dept.) $ ______________
Cashier Signature_______________________________________________Date_____________
*Dept. Signature______________________________________________Date_____________
Received by___________________________________________________Date_____________
Please complete all fields with * before returning to District Office – Thank you
-------------------------------------------------------------------------------------------------------------------
Starting Adult Ticket #___________ Starting Student Ticket #___________
Ending Adult Ticket # ___________ Ending Student Ticket #____________
Event: ______________________________
STARTING CASH $ _______________ *Please verify and initial ______________
*ENDING CASH $ _______________ Deposit Total (for Dept.) $ ______________
Cashier Signature_______________________________________________Date_____________
*Dept. Signature______________________________________________Date_____________
Received by___________________________________________________Date_____________
Please complete all fields with * before returning to District Office – Thank you
-------------------------------------------------------------------------------------------------------------------
Starting Adult Ticket #___________ Starting Student Ticket #___________
Ending Adult Ticket # ___________ Ending Student Ticket #____________
Event: ______________________________
STARTING CASH $ _______________ *Please verify and initial ______________
*ENDING CASH $ _______________ Deposit Total (for Dept.) $ ______________
Cashier Signature_______________________________________________Date_____________
*Dept. Signature______________________________________________Date_____________
Received by___________________________________________________Date_____________
Please complete all fields with * before returning to District Office – Thank you
Exhibit M
This form must be completed in full and turned in to the District Office before trip departure.
Marengo Community High School District 154 Student Trip Budget Request Form
Name of Group: Activity: ____________________
Location: _____________ Date(s): ____________________
Names of Staff Attending the Activity:
Names of Students Attending the Activity:
Meals: Food and beverage with meal only- upon return, please provide a receipt for each. Staff meals will be reimbursed
at the rate of $15.00 per meal not to exceed $40.00 per day. Student meals will be reimbursed at the following rates:
Breakfast $8.00, Lunch $12.00, and Dinner $15.00. Breakfast will not be reimbursed if it is provided with the lodging. A
worksheet is provided in the MCHS shared file to calculate totals for all meals.
Signature of Staff Member submitting the request: _________________________________ Date: __________
Approved ________________________________ Date:_________________________________
This budget must be approved by the Superintendent before the trip. If not pre approved all expense reimbursements will be
denied.
This signed form and all receipts must be returned to the District office immediately following the trip.
Alcoholic beverages will not be reimbursed by the school district.
Exhibit N
Student Trip Budget Worksheet
Fill in shaded cells only. The rest will fill in automatically.
Total # of Breakfasts
Total # of Lunches
Total # of Dinners
Number of Students
Total # of Breakfasts
Total cost of Breakfasts
Total # of Lunches
Total cost of Lunches
Total # of Suppers
Total Cost of Suppers
Total Student cost
0 $ - 0
$ - 0
$ -
$ -
Number of Staff
Total # of Breakfasts
Total cost of Breakfasts
Total # of Lunches
Total cost of Lunches
Total # of Suppers
Total Cost of Suppers
Total Student cost
0 $ - 0
$ - 0
$ -
$ -
Total Meal Request $ -
Number of Rooms
Number of Nights
Cost per Night/per room
Total Lodging Request 0
TOTAL
$ -
Please Print and attached to your budget request form.
MARENGO COMMUNITY HIGH SCHOOL DISTRICT #154
I have received the MCHS Student Activity Account Handbook. I have read the guidelines and understand the policies and expectations described therein. PLEASE NOTE: This form must be signed AND RETURNED within five (5) business days. ___________________________ ____________________ Employee Date ____________________________ Signature cc: personnel file