Village Of Trempealeau Community Room Rental Agreement Template (Page 2 of 2) in pdf

Village Of Trempealeau Community Room Rental Agreement Template Page 2

Village of Trempealeau Community Room Rental Agreement

Please fill out this form completely and fax or return to Village of Trempealeau at least one week in

advance of your rental dates.

Organization

____________________________________________________________________________

Contact person

__________________________________________________________________________

Contact phone ____________________________ email _____________________________________

Date(s) you want to use the room

____________________________________________________________

Start time _____________ End time _______________ (Please include your set-up and clean-up time.)

Briefly describe nature of your meeting(s)

_____________________________________________________

Number of persons expected to attend _______________

Will you be charging an admission fee for attendance? Y ___N___ If so, amount $_______________

Contact person for registration _______________________________ Telephone _________________

By signing this agreement, I agree to hold The Village of Trempealeau harmless from any liability for

damage, loss or destruction of property or injuries to any persons. Any claims for such loss, damage, or

injury are waived by signing this agreement. I agree to accept responsibility for any damage occurring to

the Village of Trempealeau Community Room or its contents during use or as a result of such use, and

will bear the full cost of repair including replacement, if necessary. Thank you for your responsible use of

the Community Room.

I agree to the conditions outlined in the Village of Trempealeau Community Room Rental Policy and

Application/Agreement.

Signature _______________________________________________ Date _______________________

Fee(s) Paid ________________________________

Village Of Trempealeau Community Room Rental Agreement Template Page 2