JENKINTOWN LIBRARY COMMUNITY ROOM APPLICATION FOR USE AND USE AGREEMENT

A. Applicants

1. Name of Organization:________________________________________________________

Address: ___________________________________________________________________

Telephone: _________________________________________________________________

2. Name of Individual:___________________________________________________________

Address:____________________________________________________________________

Telephone: Work___________________________Home_____________________________

B. Purpose and Number of people to use room:_______________________________________________

C. Date(s) and Time(s) requested for use of room:_____________________________________________

D. In the event the Application for use of the Jenkintown Library Community Room is granted and the Applicants use the Jenkintown Library Community Room on the dates set forth above, or any other dates, the Applicants agree as follows:

1. Applicants agree to comply with any and all policies, regulations and requirement of the Jenkintown Library, including, but not limited to, those policies, regulations and requirements attached hereto, and made a part hereof, and any and all modifications to such policies, regulations, and requirements. Applicants agree to pay any and all fees for use of the Community Room charged by the Jenkintown.

2. Applicants agree to be responsible for and hereby release and relieve the Jenkintown Library from any and all liability for any claims arising out of any loss, damage or injury to persons or property sustained by Applicants, their members or any other persons on the Jenkintown Library premises as a consequence of Applicants’ use of the Community Room. Applicants further agree to indemnify and hold harmless the Jenkintown Library from any and all claims against the Jenkintown Library arising out of Applicants’ use of the Community Room.

3. Applicants agree to conduct Applicants’ function in a lawful manner so as not to violate any code, ordinance, regulation or statute of any governmental body.

4. This agreement may not be signed by Applicants without the prior written approval of the Jenkintown Library.

5. This Application/Agreement sets forth the entire agreement between the Jenkintown Library and the Applicants and there are no premises, covenants, warrants, or undertakings either oral or written between them other than as herein set forth. No subsequent change or amendment to this Application/Agreement shall be binding upon the Jenkintown Library unless reduced to writing and signed by an authorized representative of the Jenkintown Library.

We certify that all the information in this Application/Agreement is correct and that we fully understand the terms for use of the Community Room at the Jenkintown Library and agree to comply with all such terms.

APPLICANT – ORGANIZATION

DATE__________________ BY_____________________________________

AUTHORIZED REPRESENTATIVE

DATE:__________________ ________________________________________

APPLICANT – INDIVIDUAL

ACCEPTED AND APPROVED:

JENKINTOWN LIBRARY

DATE: ___________________ BY: ______________________________________