Community Room Registration Form

Rental Date Requested (mm/dd/yyyy)*:
Start Time*:
End Time*:
Name of Sponsoring Organization or Individual*:
Name of Person Responsible for Rental*:
Are you a Sunderland organization?*	Yes     No
Are you a nonprofit or for-profit?*	Nonprofit     For-Profit
Will people be charged a fee to attend this meeting?*	Yes     No
Equipment Needed
Chairs (number):
Tables (number):
TV:
VCR:
DVD:
Screen:
Room Fee*:
Donation:
Total (Room Fee + Donation)*:
Name*:
Title:
Email*:
Mailing Address*:
Phone Number*:
Fax Number:
Notes:

I certify that I am an officer of the above named organization; that I have the authority to reserve the Community Room; and that the above statements are true to the best of my knowledge and belief.

I hereby agree that the applicant will be responsible for any damage caused by the applicant to the library premises, and furnishings because of the use of said premises by the above applicant, and agree to pay for said damages as assessed by the Library Board of Trustees.

I have read and agree to abide by and uphold all rules and policies of the Sunderland Public Library governing the use of library premises, including regulations prohibiting charging an entrance fee, soliciting donations, or limiting attendance.

I also agree to release, acquit, discharge, any and all claims or rights of action for any personal injuries or property damage which may occur as a result of the use of the above premises. I further agree to protect, save, and keep the Town of Sunderland, the Board of Trustees, the Library Director, their agents and employees forever free and harmless and indemnified against and from any and all loss, cost, or expense arising out of or from any accident or other occurrence causing injury to any person or property whomsoever or whatsoever as a result of the use of the above premises.