Subject Meeting Room Reservation Form
Date Adopted November 21, 2002
Authority Board of Library Trustees
___ Policy ___ Procedure x Rules, Regulations, and Forms
Meeting Room Reservation Form and Agreement
Lucius Beebe Memorial Library
Wakefield, Massachusetts
NOTE: No room reservation is complete until a completed, signed ORIGINAL of this form is actually received by library staff. Please make a copy of this form for your files before submitting it, and confirm with the staff that your reservation has been booked.
1. Name of Organization. The full name of the organization which seeks to use a meeting room is:
___________________________________________________________________________
2. Address of Organization. The organization has a principal place of business at the following address:
__________________________________________________________________________
__________________________________________________________________________
Telephone No.: ___________________________email_________________________________
3. Local Sponsor. The following resident of Wakefield, Massachusetts, who has signed below as “Sponsor”, affirms that the use of the meeting room has a civic, educational, philanthropic, or recreational purpose with a substantial value to the community:
By: _________________________________ Name: ____________________________
(Sponsor’s Signature) (Print name)
Address: _____________________________ Telephone No.: _____________________
Wakefield, MA 01880
4. Contact Person. In case the library staff need to contact the organization (for example, to cancel the meeting because of snow or flood), the following person should be called, and it will be his or her responsibility to notify all group members of any cancellation or other change concerning the meeting:
Name: _______________________________ Telephone No.: ______________________
(Print name)
Address: ______________________________________________________________________
Note: the contact person need not be the same person identified in 3, above, as the Sponsor.
5. Type of Organization. The organization is the following (check one and fill in any applicable blanks):
____ a non-profit corporation incorporated in the state of ______________________
____ an unincorporated association
____ other (please describe: _____________________________________________
6. Past Meetings. The following is a complete list of the locations where the organization has held meetings during the past two (2) years:
Name of Facility – Date – Address - Telephone No.
_________________________ _________ _____________________ ______________
_________________________ _________ _____________________ ______________
_________________________ _________ _____________________ ______________
_________________________ _________ _____________________ ______________
_________________________ _________ _____________________ ______________
Attach additional sheets if necessary.
7. Date and Time of Booking. The organization desires to reserve a meeting room for the following time(s) and date(s) (not to exceed 12 per year) and estimates the number of people who will attend the meeting as follows:
Date - Meeting Room – Starting Time – Ending Time – Size
_________________ ________________ ___________ __________ _____________
Title of program:_________________________________________________________
Date - Meeting Room – Starting Time – Ending Time – Size
_________________ ________________ ___________ __________ _____________
Title of program:_________________________________________________________
Date - Meeting Room – Starting Time – Ending Time – Size
_________________ ________________ ___________ __________ _____________
Title of program:_________________________________________________________
Date - Meeting Room – Starting Time – Ending Time – Size
_________________ ________________ ___________ __________ _____________
Title of program:_________________________________________________________
Date - Meeting Room – Starting Time – Ending Time – Size
_________________ ________________ ___________ __________ _____________
Title of program:_________________________________________________________
Date - Meeting Room – Starting Time – Ending Time – Size
_________________ ________________ ___________ __________ _____________
Title of program:_________________________________________________________
Attach additional sheets if necessary.
8. Indemnification. The undersigned organization hereby agrees to hold the Board of Library Trustees, and the Town of Wakefield, and all library staff, harmless from and to indemnify them against all costs, damages, losses, claims, and expenses incurred, directly or indirectly, as a result of such organization’s use of a meeting room. Such costs, damages, losses, claims, and expenses shall include, without limitation, any damage to the meeting room or any other part of the library building, grounds or collection; the cost of employee overtime, if occasioned by the use of the meeting room; the cost of police protection, if deemed necessary by the Board of Library Trustees; and any claim asserted by any third person against the Board of Library Trustees, the Town of Wakefield, and/or any library staff on account of any alleged injury causally related to the meeting, together with defense costs including reasonable attorneys’ fees.
9. Release. In consideration of the use of the meeting room, the undersigned organization, for itself and each and all of its members, hereby releases, remises and waives any and all claims which they, or any of them, ever will or may have against the Board of Library Trustees, the Town of Wakefield and/or the library staff for any injury to persons or damage to property suffered by such group or any of its members during or as a result of the use of the meeting room, except insofar as such injury or damage is directly and solely caused by the negligence or intentional misconduct of any person belonging to or acting on behalf of the Board of Library Trustees, the town government of the Town of Wakefield or the library staff.
10. Meeting Room Policy. The undersigned, on behalf of the organization, acknowledge(s) receipt of a copy of the Meeting Room policy of the Board of Library Trustees of the Lucius Beebe Memorial Library and agree(s) to abide thereby.
Witness our hands and seals as of this ______ day of _______________, 20____.
___________________________________
(Name of organization)
By: ________________________________
(Signature)
Name: ______________________________
(Print name)
Title: ______________________________
Address: ____________________________
____________________________
Phone: ____________________________
![[Wakefield Public Library]](http://www.wakefieldlibrary.org/wp-content/themes/wakefield/images/logo_hive_yellow.gif){kind=logo}