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2. Meeting Room Use Agreement
   A completed application must be submitted for each date of use. Each application will be reviewed and the applicant will be contacted in regards to the status of her or his application within 48 hours. Reservation for the meeting room are not confirmed until the application has been approved. Programs are scheduled 30 minutes after opening and 30 minutes before closing. View Meeting Room Policy (PDF)
4. Today's Date*
   Today's Date
6. Date Needed*
   Date Needed
7. Event Start Time to Event End Time*
   Event Start Time to Event End Time Start Time

   —

   Event Start Time to Event End Time End Time
9. Organization Name
11. Subject of Meeting*
13. Contact Person First Name*
14. Contact Person Last Name*
16. Phone Number*
17. Email Address
19. Address*
21. City*
22. State*
23. Zip Code*
25. Alternative Contact First Name
26. Alternative Contact Last Name
28. Phone Number
29. Email Address
31. Approximate number of participants
33. Equipment Request List*

    Please arrive early to receive items reserved and/or technical assistance on the day of event. Please select none if you do not need any of the listed equipment.

    1. Kitchen
    2. Library Display / Literature
    3. Library's Laptop
    4. Microphone
    5. None

    1. Personal Laptop
    2. Table / Chair Set Up
    3. Technical Assistance
    4. TV / VCR
    5. Whiteboard / Markers
35. I accept full financial responsibility for the loss or damage of any equipment checked out.
    Initial
37. Additional Comments
39. Your Responsibilities as the Requester
    - Arrange the room to accommodate your needs within reason
    - Return the room back to its original setup
    - Provide the library staff with the actual number of attendees
    - Contact person will receive a phone call to confirm or reschedule your date
    
    All regular scheduled meetings must end 30 minutes prior to library closing unless otherwise approved by the Library Director.
    
    In consideration of this agreement being accepted, and desiring to be legally bound to myself, my heirs, assigns, executors, and administrators, I/we hereby waive and release the County of Warren from responsibility for any injuries, physical or otherwise, received by any person in our group participating in activities in or on the Warren County Memorial Library premises.
    
    After the meeting, please notify staff of the actual number of participants who attended.
41. E-Signature*
Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit Submit and Print

* indicates a required field