Hornell Public Library Hand-Saxon Room Application
The Hand-Saxon Room (H.S.R.) is available for public use when not required for Library programs.  This form should be completed by any individual or group at least two weeks in advance of the need, and use of the room is at the discretion of the Library Director.
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Name of Organization / Individual: *
Person responsible over age 18 (if user is an "Organization", this must be someone authorized to sign a contract on behalf of the Organization): *
Mailing Address: *
Phone / Cell Number: *
Email: *
Date(s) of Use: *
Start Time: *
End Time: *
Description of Program / Activity: *
Goals/Objectives of the Program/Meeting: *
Estimated Number of Attendees: *
Request for use of Conference Room Technology:
(*Training on all equipment being requested for use is required, along with signing equipment and internet usage agreements)
*
Meeting Room Rules for Use.  Please check or initial next to each statement to indicate agreement: *
Required
Hold Harmless and Indemnification

The individual or organization arranging to use the room agrees to hold harmless, indemnify, and defend the Hornell Public Library, its officers, directors, agents, representatives, managers, employees and affiliates from and against any and all claims, suits, liens, judgements, damages, losses and expenses including reasonable attorney fees and legal expenses, incurred in relation to this conditional use of the Library's property.

Please sign below indicating agreement:
*
Acknowledgements

As the "responsible party" listed above, my signature below indicates that I have read and agree to the Hand-Saxon Room Use Policy:
*
As the responsible party, my signature below indicates that I have read and will abide by, and direct attendees to abide by, the Patron Code of Conduct and the Hand-Saxon Room Use Guidelines: *
My signature below indicates that I agree that I, or the organization I represent, will assume full responsibility for any damages or additional cleaning fees. *
I / We or My / Our organization, its officers, employees and members shall, through the signing of this Agreement by an authorized party or agent, agree to exercise the utmost care in the use of the Library facility, the surrounding property, and to hold the Library harmless from all damages, liabilities, injuries, or losses to persons or property resulting from use of Library facilities.  Please sign below indicating agreement: *
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