Town of Granby - Meeting Room Form

Town of Granby

Department of Library Services

Granby Public Library 860.844.5275; FAX 860.653.0241

Cossitt Library Branch 860.653.8958

Meeting Room Use Request

Name of applicant (and organization/group):

Address:

Please provide a phone number where we can contact you about this request:

Date(s) and Time Room is needed:

How many people will be using the room?

Room requested:

Study Room # 1 (12 people)_____

Study Room #2 (4 people)_____

Children's Program Room_____

Cossitt Library Adult Room_____

Cossitt Library Children's Room_____

THE APPLICANT AGREES TO FOLLOW THE GUIDELINES ESTABLISHED BY THE TOWN OF GRANBY AND LIBRARY MEETING ROOM RULES

HOLD HARMLESS AGREEMENT: User agrees that it will indemnify and hold harmless the Town and its respective officers, agents and employees from any loss, cost, damage, expense and liability whatsoever kind or nature resulting directly or indirectly from the nature of use covered by this contract which results in bodily injury including death, personal injury or damage to property.

____________________________________________________________

Signature of Applicant

This form may be printed. The completed form may be mailed or faxed to the Granby Public Library, or dropped-off at the main check-out desk at Granby Public Library.

For staff use:

Room Use Confirmed_____

Room Use Denied_____

Information on Calendar_____

Copy of Policy Given to Applicant_____

6/2008