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Town Hall Usage Request Form 2010-01-19 JCM FOR INTERNAL USE ONLY Town of Wappinger Agreement for the Use of the Town Hall Facilities for Meetings Received by: Christine Fulton 0 Sue Rose 0 Date Received: / / o Application 0 $100.00 o Notified Recreation (date: o Cert. of LI ) Serial #: Agreement for the Use of the Town Hall Facilities for Meetings Name of Organization or Group Name of person representing the Organization or Group Address Phone No. This will confirm the arrangements being requested for your groups' use of the Wappinger Town Hall Facilities, as noted below: ( ) Senior Citizens Room ( ) Large Meeting Room ( ) Other: Specify: The group is not expected to exceed Date(s): persons Time: It should be understood that groups using the Buildings' Facilities for evening meetings must select dates when Town Meetings are normally scheduled (i.e., Justice Court, Planning Board, etc.) Special requests will be considered upon their own merit, and arrangements can be made for access to, and closing, the building at the close of your meeting. You and your Organization hereby agree to adhere to the rules set forth on the attached page by signature of an authorized member of your Organization or group. The Town of Wappinger reserves the right to suspend temporarily this agreement should the Town have need of the facility for its own purposes. Advance notice will be given as soon as possible on such occasions. The Town Clerk should be informed promptly of any schedule change or cancellation of your group activities. Arrangements for access to specific area to be used should be made with the Town Clerk at the time this form is submitted. No application shall be considered approved until it has been submitted to the Town Clerk for review and Clearance. 2010-01-19 JCM Terms of the agreement must be strictly adhered to by the contracting group as any disregard or abuse of the rules for use of the facilities will result in termination of use by the offending group, and they will not be granted reinstatement. I have read and understand the rules and regulations for the use of the Facilities in the Town of Wappinger Town Hall, and will comply with these requirements. Signed: For: (Name of Group or Organization) Date: Approved: Town Clerk Date: 2010-01-19 JCM Rules For Use Of Town Hall Facilities For Group Meetin2s 1) Using Group assumes responsibility for any damage to furnishings, equipment, or property. 2) Food, beverages, and paper products, ifused, will be provided by using group. 3) Group using Senior Citizen Room shall not use the TV, Kitchen, or Kitchen equipment andlor Senior Citizen provisions. 4) No food or beverages are to be furnished and lor served when using the Large Meeting Room. 5) Using group agrees to restore tables, chairs, etc. to places where found at beginning of session, clean tables and discard rubbish, if applicable. 6) Groups using Senior Citizen Room will close and lock windows and doors and turn off lights at end of each session. 7) Strict adherence to: "NO SMOKING" regulations must be observed.