Form Center

2. Sterling Heights Library Programming Center Reservation Form
4. Organization*
5. Today's Date*
   Today's Date
   MUST BE AT LEAST 48 HOURS BEFORE MEETING
6. Projected Attendance*
8. Description and Purpose of Meeting*
10. Name of Applicant*
    MUST BE PRESENT AT MEETING
11. Applicant's Sterling Heights Public Library Card Number*
13. Applicant's Address*
15. City*
16. State*
17. Zip*
19. Name of Contact Person*
20. Phone Number*
22. Email*
24. Requested Setup*
    (number of chairs, tables, and arrangement desired)
26. Date of Meeting*
    Date of Meeting
27. Time to be Reserved*
    Time to be Reserved Start Time

    —

    Time to be Reserved End Time
    (please allow time for set up and clean up of room)
28. Actual Start Time
    Actual Start Time
    (if different than "Reserved")
30. Upon approval, would you like a copy of the approved form emailed to you?

    1. Yes
    2. No
32. ROOM MUST BE VACATED 15 MINUTES PRIOR TO CLOSING OR FUTURE RESERVATIONS MAY BE DENIED
34. Liability Waiver/Indemnification Agreement
    I have received, read, understood, and agree to comply with the Sterling Heights Public Library's Library Programming Center Use Policy.
36. I hereby fully release and discharge the Sterling Heights Public Library, the City of Sterling Heights, its officers, agents and employees from any and all claims from injuries, including death, damages or loss, which may arise or which may be alleged to have arisen out of, or in connection with the above meeting in the Sterling Heights Public Library.
38. I further agree to indemnify and hold harmless and defend the Sterling Heights Public Library, the City of Sterling Heights, its officers, agents and employees from any and all claims resulting from injuries, including death, damages and losses, including, but not limited to the general public, which may arise or may be alleged to have arisen out of, or in connection with the above meeting in the Sterling Heights Public Library.
40. Applicant's Electronic Signature*
    Persons reserving the meeting room must be at least eighteen years of age and a resident of Sterling Heights.
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42. Submit

* indicates a required field