student activity account handbook filefieldtrip/overnight trip/bus request form (exhibit b) school...

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Student Activity Account

Handbook Marengo Community High School

110 Franks Rd

Marengo, IL 60152

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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

http://www.mchs154.org/

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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


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


Exhibit E

SCHOOL TRIP


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 $_____________________.

__________________________________ _______________________ ___/___/___.


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 G

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


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


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

-------------------------------------------------------------------------------------------------------------------



Event: ______________________________





Received by___________________________________________________Date_____________


-------------------------------------------------------------------------------------------------------------------



Event: ______________________________





Received by___________________________________________________Date_____________


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 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 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