APPLICATION FOR USE OF MEETING ROOM

Scott County Public Library

104 South Bradford Lane

Georgetown, Kentucky 40324

 Circle the facility for which you are applying:

Large Meeting Room

Kitchen

Conference Room (10-12 people)

NAME OF GROUP:_________________________________________

 Date of Meeting:____________________________________________

Name of Individual Making Request:____________________________

(If group is composed of persons under age of 18, name of Adult Supervisor)

 Address:___________________________________________________

 Phone (daytime)_________________ (evening)____________________

 Nature of Meeting:___________________________________________

 Number Expected to Attend:___________________________________

 Requested Time for setup:_______________

 Meeting Time Begins: _________________Closes:_________________

 Requested Time for clean-up:______________ 

AGREEMENT BY USER

In consideration for the use of the meeting rooms at the SCPL, the group agrees that:

·        It will leave a $25.00 good faith deposit upon booking

• It will pay for all damages to any property of the Scott County Public Library resulting directly or indirectly from the conduct of any member, officer, employee or agent of the organization or any of its invitees and forfeit the deposit fee.
• It will take responsibility for compliance with the American Disabilities Act.
• It is understood that the Scott County Public Library assumes no responsibility whatsoever for any property placed in the library in connection with a meeting, exhibits, or display; and that the Scott County Public Library hereby, expressly released and discharged from any and all liability for any loss, injury or damage to persons or property which may be sustained by reason of a meeting, exhibit, or display.

I have read and understand the policy for the use of the meeting rooms and agree to follow the rules set forth.  I understand that the library director and library board reserve the right to discontinue meeting room privileges to any group/individual who infringes on the rules as defined in the policy.

SIGNED:_______________________________________________________________

DATE:_________________________________________________________________

Return signed form to:  Information Desk, Scott County Public Library, 104 South Bradford Lane, Georgetown, Kentucky 40324, (502) 863-3566, (502) 863-9621 fax.