| KILGORE PUBLIC LIBRARY Email: linda.johnson@cityofkilgore.com 301 N. HENDERSON BLVD. Webpage: www.kplkids.org KILGORE, TX 75662 Phone: 903 984 1529 Fax: 903 983 1779 KILGORE PUBLIC LIBRARY Room Reservation Request Today’s Date _______________________ Name of Organization: __________________________________________________________________________ Address: _____________________________________________________________________________________ Telephone Number(s): ___________________________ Web Address: __________________________________ Fax Number: __________________________ Email Address: __________________________________________ Name of Representative Making the Request: ________________________________________________________ Position in the Organization: ______________________________________________________________________ Purpose of the Meeting: _________________________________________________________________________ Date and Time of Meeting:______________________________Approx. Group Size: _________________________ Day(s): __________________________ Hours: __________________________ to: _________________________ Check if you wish the librarian to approve the serving of light refreshments. (Alcohol is prohibited) AGREEMENT It is expressly understood that the Library has adopted certain rules applicable to the use of the Library meeting room, a copy of such rules being attached hereto as Exhibit A, Meeting Room Policy. The undersigned has read and understands the terms of such Policy and agrees, individually and as a representative of the group as a whole requesting use of such facility, to comply with the terms therein and said individual and group as a whole shall be liable for any noncompliance thereof, to include, but not limited to, and all damage that may occur or fees or costs that may be incurred as a result of the use of the Library facilities. The individual making the reservation, as well as the membership of the group as a whole, agree to indemnify and hold the City harmless from and against any and all losses, expenses, demands, and claims made against the City arising in any manner from such group’s use of the library facilities, whether such losses, expense, demand, or claim made against the City is caused by the City’s negligence or not. Group Name: ________________________________________________ ___________________________________________________________ SIGNATURE Printed Name: _______________________________________________ Received by (library staff member):_________________________ Refreshments: Yes____ No_____ Comments: __________________________________________________________________________________ Approval by Library Director or Assistant Director: ________________________________________________________________ Date: ______________________ Signature |
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