Application for Use of Potter Hall

 

South Kingstown Public Library

Kingston Free Library

2605 Kingstown Rd., Kingston RI 02881

401-783-8254

 

Organization Represented___________________________________

 

Applicant's Name__________________________________________

 

Address_________________________________________________

 

Date(s)requested__________________________________________

 

Hours of Meeting___________________________________________

 

Purpose of Meeting/Description________________________________________

 

________________________________________________________

 

it is understood that all policies and procedures described on the attached sheets will be carried out. The person or officer of the organization making application will be responsible for meeting with the Head Librarian prior to using Potter hall to review opening/closing procedures. Said person will also be fully responsible for the condition of the hall.

 

Name and phone number of person to be responsible for keys to the building: _________________________________________________________

 

I, (Name)_______________________________________, in consideration of use of the South Kingstown Public Library ("Facility"), do hereby on behalf of myself, my successors, heirs, and assigns, remise, release, and forever discharge the Town of South Kingstown and the South Kingstown Public Library Trustees and staff (employees ahd volunteers), their successors and assigns of and from any and all accounts, reckonings, covenants, contracts, controversies, agreements, promises, damages, judgments, executions, claims, and demands whatsoever, in law, or in equity, which I may have, or which I may have in the future, as a result of my use of the Facility.

 

Signature____________________________________________

 

Title______________________________________

 

Date_______________________________________

 

1/09