Annual Meeting Room Agreement Form

Please print this form and mail or fax it with requested information to:  Adult Services Department, Eastern Monroe Public Library, 1002 North Ninth Street, Stroudsburg, PA 18360. Fax number: (570) 421-0212
Name of Group:

Address:

Contact Name:        

Phone Number:                                         Email Address:

Is this a non-profit group? _____yes   ______no

Meeting Date:  mo_________ day________ year_________  start time _______ end time ________

Is this a periodic meeting? If so, please specify it as monthly, or bi-monthly.

*How many people will be attending the meeting?

Please specify how many tables/chairs and what type of equipment are needed (EMPL does not promise room set-up but will try to make sure the tables and chairs needed are available):

You may provide the library with a summary of your group's purpose and activities in order to attract new members. Please include a summary on the back of this page and no more than 200 words, if you would like it to appear on the library's website. Also include contact information if desired.

Awareness of Library Policies

I am aware that free use of the Eastern Monroe Public Library's meeting room facilities is only available to non-profit groups. I agree to abide by all procedures and stipulations stated in the Eastern Monroe Public Library Use of Meeting Room/Library Facilities document.  I agree to notify the reference desk in the event that a scheduled meeting is cancelled. I understand that the room should be left clean and ready for the next user. Although the library will make every effort to honor all reservations, I understand that the library reserves the right to change room schedules.  If the library closes due to weather or other emergencies, all meetings will be cancelled.  Notification of library closing is made on WVPO and WSBG radio.

Indemnification of EMPL
The above named group conducting a meeting or presenting a program on library premises will assume full responsibility for property damage or injuries sustained by its members or participants while on EMPL premises and for any harm or injury caused by its members/participants to others on the premises.  The Eastern Monroe Public Library will be held harmless for such bodily injuries. Circumstances may require the library to request proof of insurance.

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Signature                                                                                Date

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Printed Name