Carol Stream Public Library

RESPONSIBILITY STATEMENT FOR USE OF MEETING ROOM

I have read the Statement of Policy with regard to use of the meeting room, and our organization will adhere to all rules as stated:

I, _______________________________________, the duly authorized agent of
Name of person signing agreement

___________________________________________, (the "Organization"),
Name of Organization
and/or the individuals comprising the Organization (if not incorporated, the "Members") have read the Statement of Policy with regard to the Meeting Room, the terms of which are incorporated in this Agreement by reference, and represent and agree that the Organization and the Members will adhere to all rules as stated in the Statement of Policy.

The undersigned, the Organization and/or the Members agree to defend, indemnify, and hold harmless the Board of Library Trustees of the Village of Carol Stream, its agents, officers, and employees from all claims, suits, losses, damages, and expenses, including reasonable attorney’s fees, which arise from performance or failure to perform under terms of this Agreement, or from the use of Library premises or facilities by the Organization and/or Members, regardless of whether any such claim, suit, loss, damage, or expense is attributable to negligence or other wrong doing of the Organization and/or the Members.

_______________________________________________ Dated: ____________________
Name of Organization

By: ___________________________________
Signature

The ________________________________ of the Organization and a duly authorized agent for the Organization and Members.

Please submit application to:

Meeting Room Coordinator
Carol Stream Public Library, 616 Hiawatha Drive, Carol Stream, IL 60188

Received: ________ By: ____________
(Initials) Staff Member

Application
Approved: ________ Denied: ________

 

___________________________________ ________________________
(Signature) Meeting Room Coordinator                  Date

 

 

c2007 Carol Stream Public Library
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