Applications must be submitted to the Library Director's Office at least 30 calendar days in advance of the requested date of use. Library related activities take precedence over other organizations' use of the meeting room. The Library Board of Trustees reserves the authority to reassign your scheduled activity in case of conflict.
A. Name of Organization ____________________________________ Tel. # _________________
Address ______________________________________________________________________
Responsible Official _____________________________________ Tel. # _________________
Address ______________________________________________________________________
B. Date(s) Requested _____________________________________________________________
C. Hours Requested _______________________________________ Total Hours _____________
D. Estimated Attendance Number ___________________________________________________
E. Will food or drink be served? ____________________________________________________
F. Will admission be charged? _______ If yes: Amount for Adults ______ Children _______
Purpose for which proceeds will be used? ___________________________________________
G. Description of Planned Event _____________________________________________________
I, the undersigned responsible official, state that I am authorized to sign this application on behalf of the organization I've noted on this application and bind said organization to the statements and regulations of the Thrall Public Library District of Middletown & Wallkill pertaining to the USE OF THE MEETING ROOM which accompanied this application and do assume complete responsibility of behalf of the organization which I represent. Both the organization and I fully accept the conditions as established therein, including insuring reimbursement to the Library property as a result of the organization's use of the same. Additionally, both the organization and I hereby agree to indemnify, defend and hold of the Board of Trustees, Thrall Public Library District of Middletown & Wallkill and their agents and employees harmless from and against any and all claims, liabilities, lawsuits, actions and proceedings which may arise from or in connection with the use of the Library facilities by the organization.
Signature ____________________________ Date _______________________