Matteson Public Library
MEETING ROOM RESERVATION
AND USE AGREEMENT
Date: ________________________________________________________________________
Name of Organization / group:
Type of Group: (please check one) Government o Community Organization o
Friends of the Library o Business ($50.00 per day) o
Representative (must be 18 or older and attend the entire meeting)
Representative’s Matteson Public Library card number:
2 1486
Representative’s address_________________________________________________________
Representative’s Phone numbers: Home: ___________Work:____________Cell:_____________
Alternate: Name: __________________________ Library card # 2 1486___________________
Phone numbers: Home: _______________ Work: _______________ Cell: _________________
Meeting Room Reservation:
A single group may book up to 12 meetings per calendar year. Meeting rooms may be reserved up to 3 months in advance, but no less than two weeks in advance. See the Rules and Regulations for more details.
Meetings may be scheduled during the following times:
Include set up and clean up time when reserving the room. The meeting room must be vacated at least ˝ hour before closing.
Date / Time requested (one meeting date per form)
Date: __________________________________ Day: __________________________________
Start Time: ______________________________End Time: ____________________________
Alternate Date(s) / Times requested:
Date: _________________________________ Day: ___________________________________
Start Time: _____________________________ End Time: ______________________________
Date: _________________________________ Day: ___________________________________
Start Time: _____________________________ End Time: ____________________________
Purpose
The meeting room will be used for the following purpose: ________________________________
____________________________________________________________________________.
Fees
Businesses: $50.00 per day ___________
Use of Library’s A/V equipment $25.00 per day ___________
Total: ___________
List A/V equipment needed ______________________________________________________
_____________________________________________________________________________
All fees must be received no later than two (2) weeks before the date of the program or meeting.
Consent:
o I herby acknowledge that I have read and I agree to abide by the Matteson Public Library’s Meeting Room Policy and Rules and Regulations. Furthermore, I understand that failure to comply with Meeting Room Policy and Rules and Regulations may result in a loss of meeting room privileges.
o I, and the agency, group, organization, or business I represent, will ensure compliance with the code restrictions relating to meeting room occupancy limits and with fire and safety regulations.
o I and the agency, group, organization or business I represent, will be responsible for all others in the room during our use of the Matteson Public Library’s meeting room.
o I and the agency, group, organization or business I represent, will be responsible for the willful or accidental damage by attendees, during our use of the meeting room, of the library building, grounds, furniture and/or equipment and shall be responsible for the prompt reimbursement to the Matteson Public Library for any damage to the above said library building, grounds, furniture and/or equipment.
o I, individually and on behalf of the agency, group, organization or business I represent, must indemnify and hold harmless the Matteson Public Library, its Board of Library Trustees, all library staff, and the Village of Matteson for any and all accidents, should any be incurred arising from or during the course of our use of the room, pursuant to this application.
o I will be present throughout the scheduled meeting.
o I will include the statement “The Matteson Public Library is not a sponsor of the organization and its programs” on all publicity. All publicity must be approved by the Library Director prior to the event.
o I will not use the library’s address and/or phone number as my organization’s contact point.
Date: _______________ Representative’s signature: ___________________________________
TO REQUEST A MEETING ROOM, THIS COMPLETED FORM MUST BE SUBMITTED.
RESERVATIONS ARE NOT FINAL UNTIL CONFIRMED BY SIGNATURE BELOW.
Date application received by staff: __________________________________________________
Received by: __________________________________________________________________
Date application received by administration: __________________________________________
Received by: __________________________________________________________________
o APPROVEd
Date: __________________________________________________________________
Staff Signature: __________________________________________________________
o NOT APPROVED
Date: _________________________________________________________________
Staff Signature: _________________________________________________________
Reason: ________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Notification mail date: __________________________________________________________
Matteson Public Library
801 School Ave. - Matteson, IL 60443
Web page: www.matteson.lib.il.us Email: mtslib@sslic.net
Phone: 708 748-4431 - Administrative Fax: 708 748-0579