Home 

Activity Date: ________________________________________________

Time: _____________________________________________________

Name of Group/Individual: ______________________________________

Purpose of Reservation: ________________________________________

Person in Charge: ____________________________________________

In consideration of the use of the Allegan District Library facility located at 331 Hubbard Street, Allegan, MI 49010.

All rules and regulations are to be adhered to as per ADL’s Meeting Room Policy.

Indemnification Agreement:

For the _____________________________________ agrees to defend, indemnify and hold harmless the Allegan District Library from any claim, demand, suit, loss, cost of experience, or any damage which may be asserted, claimed or recovered against or from Allegan District Library by reason of any damage to property, personal injury or bodily injury, including death, sustained by any person whomsoever and which damage, injury or death, arises out of or is incident to or in any way connected with the performance of this contract, and regardless of which claim, demand, damage, loss, cost of expense if caused in whole or in part by the negligence of the reserving party, or by third parties, or by the agents, servants, employees or factors of any of them.

Signature: _____________________________________ Date: _____________

Approved by: ___________________________________ Date: _____________