Application for Use of Facility
Organization Name: _________________________________________
Purpose for the Group/Organizaton: ___________________________________________________________
_________________________________________________________________________________________
Sponsoring Organization Contact:
Name: __________________________________________________________
Street Address: ___________________________________________________________________________
City: ___________________________________________ State: _____________ Zip: __________________
Telephone: ________________________________________________________
Email: ____________________________________________________________
Individual Submitting Application (if different from above):
Name: ____________________________________________________________
Telephone Number: __________________________________________________
Proposed Use of Requested Facility: __________________________________________________________
____________________________________________________________________________________________________
_____________________________________________________________________________________________________
Will Food and/or Beverage Be Served: Yes _______ No _______
Will any Outside Equipment Be use to Facilitate this Meeting? Yes _______ No _______
If yes, List All Equipment: ________________________________________________________________
____________________________________________________________________________________________________
Does a Certificate of Insurance Accompany this Application? Yes _______ No _______
The undersigned user of the metting room has read the St. Joseph Public Library Meeting Room Policies and understands and agrees to abide by the guidelines and rules described therein. Failure to abide by these rules may disqualify the organization from future use of the rooms as a minimum penalty.
The Library is not responsible for lost or stolen items. Damages to the premises, equipment, or furnishings as a result of meeting room use will be charged to the group responsible. The group or organization and its members, jointly and serverally, will assume and bear full responsibility for loss, or injury, or damage to any property of the St. Joseph Public Library caused by the organization, its members, affiliated persons, guests or invitees.
Every person, group, or organization using library facilities shall indemnify, hold harmless, and defend the library, its Board of Directors, and its employees from any and all liability or financial loss, costs, or expenses (including reasonable attorney’s fees and legal costs) resulting from any suits, claims, losses, or actions brought against the library and/or employees which result directly or indirectly from wrongful or negligent actions of permittee including its sponsor(s), spectators, participants, members, officers, directors, or agents. Wrongful or negligent actions include, but are not limited to, failure to adequately inspect, discover and remedy, or warn of defect in the premises or grounds.
Applicant’s Authorized Representaive:
Name (print): _____________________________________________________________________________
Date: __________________________________________________
Signature: _______________________________________________________________________________
