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..
~O" <SUe..
2010-01-19 JCM
Received by:
emis Masterson 0
Chtistine Fulton .~
Sue Rose ~
~...I_LJ Ie)
4ft g
Town of Wappinger
Agreement for the Use of the Town
Hall Facilities.for Meetings
.y-J,
FOR INTERNAL USE ONLY
Date Received:
Serial #:
~pplication 0 S! 00.00
~N~tified Recreation (date:
o Cert. of LI
)
Agr~!ement for the Us e of the Town Hall Facilities for Meetings
~OQilc\ rR ,..~I
Name of Organization 0:1' Group
~f:\J~ Go~:.V
Name of person representing the Orgcwizatiof. or Group
4, C~O~ Y~hl{~~^;Q_ N.~
Address ~
J.:1bo I
~~;L)c9-l
Phone No.
This will confinn the arrangements being reqt: ested for your groups' use of the Wappinger Town Hall Facilities; as
noted below;
( ) Senior Citizens R)()m
( ) Large Meeting R< <>m
( ) Other: Specify: _.. C6-u."(\.~ l2..ttTM
The group is ~e(. to exceed '" 0 'persons
Date(s): ~:O I 0 Time:
1
It should be undel'Stood filat groups using the Euildingst Facilities for evening meetings must select dates when
Town Meetings are norm~ll.ly scheduled (Le., 111Stice Court, Planning Boanl, etc.) Special requests will be
considered upon their owu merit, and arrangeuents can be made for access to, and closing, the building at the close
of your meeting.
You and your Organizatio tl. hereby agree to ad] Lere to the rules set forth on the attached page by signature of an
authorized member of YOllr Organization or gn up.
The Town of Wappinger t':1serves the right to sllspend temporarily this agreement should the Town have need of the
facility for its own purpOS4~S. Advance notice w [11 be given as soon as possible on such occasions.
The Town Clerlc should b~~ informed promptly Ilf any schedule change or cancellation of your group activities.
Arrangements for access to specific area to be t sed should be made with the Town Clerk at the time this fonn is
submitted.
No application shall be col:lsidered approved uti :il it has been submitted to the Town Clerk for review and
Clearance.
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Terms oftbe agreement rnust be strictly adhe: 'ed to by the contracting group as any disregard or abuse of the rules
for use of the facilities wi,U result in teuninati m of use by the offending group, and they will not be granted
rein,statement.
I have read and understa,n,d the rules and regu ations for the use of the Facilities in, the Town of Wappinger Town
Hall, and will comply w:,'lh these requirement i.
~!:4-
"For: ~_
(Nu le of Group or Organization)
Date: l1- I - Hl/I~
Appro.oo: ~f~
Date: M I 0