Date Required:   ___________________

The Blue Mountains Public Library

MEETING ROOM BOOKING APPLICATION

Name of Group or Event:

Contact Person:                                                          Tel Number:                                        

Date(s) Required:                               

Hours:  From:                                    To:                                  

Description of Event:                                      

Attendance Estimate:                                    

Will this be a licensed event?   Yes      No        
If YES, renter is responsible for obtaining a liquor license/special event permit for the event.
The renter understands that all setting up, taking down and cleaning up are the renter’s responsibility.
Yes       No       

ROOMS NEEDED:

Board Room @ $20 / 3 hour block         Gallery Room @ $35 / 3 hour block             

TOTAL COST $                    Deposit                     Balance                    

The reservation as specified above is confirmed and money has been received in the amount of $                               

Date:                                                      Authorized Signature:                                                         

SPECIAL EQUIPMENT NEEDED :

EQUIPMENT AVAILABLE IN GALLERY STORAGE :
6 Rectangular Tables              3 Round Tables            3 Wooden Tables         100 Chairs

It is understood and agreed between the Applicant and the Leonard E. Shore Memorial Library that the
Conditions of Use regulations have been read and will be observed.

Signature of Applicant:                                              
   

BOOKING CONFIRMATION:  Date of Booking:                             Method:      Telephone       In-person     

The Blue Mountains Public Library        

173 Bruce St. S,  P.O. Box 580, Thornbury, ON  N0H 2P0

Tel:  519-599-3681       Fax:  519-599-7951      www.thebluemountainslibrary.ca

  Authorized Signature: