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SM/SF 2022-2023 San Mateo County 4-H Facility Use Agreement and Certificate of Insurance Request


Facility Use Agreements & Insurance for 4-H Units


UC maintains a self-insurance program for general liability that protects all UC employees and agents while acting within the course and scope of UC business. Adult volunteers are UC agents when actively engaged in the course and scope of UC volunteer activities and thus are covered. Coverage is provided for the supervision of people and general supervision of UCCE sponsored programmatic activities. Please see the State 4-H policy regarding General Liability Insurance and Liability Insurance for Adult Volunteers and see the brochure Liability Insurance for ANR Formal Volunteers.

  • 4-H Club Leaders and 4-H Project Leaders are responsible for maintaining a written record of all 4-H meetings, activities, functions, and events. This record will help ensure documentation of authorized 4-H activities. 

Facility Use Agreements

Per State 4-H policy, 4-H volunteer leaders cannot sign facility use agreements. Please see the State 4-H policy regarding License Agreements for Use of Facilities (FUA). County directors are the only county-based administrators authorized to execute license agreements. All FUA's should name 'The Regents of the University of California' as the Licensor.

Requesting a Facility Use Agreement and Certificate of Insurance

Many facilities require a signed facility use agreement and a copy of UC's certificate of insurance. To initiate processing, please provide the information requested below. Facility Use Agreements for 4-H meetings (Club, Projects, and others) must be submitted at least 30-days prior so all paperwork can be processed.

Health and Safety for Meeting Locations

The University of California and the California 4-H Youth Development Program is committed to achieving excellence in providing a healthy and safe program and working environment, and to support environmentally sound practices. Please see the State 4-H policy regarding Health and Safety.

Holding Meetings in Private Residences

When a 4-H meeting is held in a private residence, the host and guests each assume roles with responsibilities that contribute to productive, safe, and successful meeting outcomes.


If you have any questions please contact the UCCE San Mateo/San Francisco Counties 4-H Youth Development Program at

To request a Faciltiy Use Agreement and/or Certificate of Insurance, please complete the following information:


Please contact the facility you wish to use to set dates and determine if they will require a certificate of insurance or contract/agreement.


Contracts or agreements must be reviewed and signed by the County Director. Please upload the contract or agreement at the bottom of this survey.


Upload any documents (i.e., contracts, agreements and any other pertinent information).

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