610-432-4339

3700 Mechanicsville Road, Whitehall, PA 18052

Meeting Room Reservation Form

Meeting Room Reservation

  • A signed Meeting Room Reservation Form needs to be completed and submitted no later than 7 days in advance of the meeting. See page 3 of the Meeting Room Rental Policy below.
  • Organization Information:

  • Program Information

  • Date Format: MM slash DD slash YYYY
  • :
  • Please enter a number from 1 to 44.
  • Equipment Requested

  • Please enter a number from 1 to 5.
  • Please enter a number from 1 to 44.
  • Insurance

  • A certificate of insurance (if applicable to my group as outlined in the library’s Meeting Room Policy) is delivered with this Meeting Room Reservation Form with limits of at least $500,000.00 each occurrence, $1,000,000.00 aggregate, which lists the Whitehall Township Public Library, its board members, employees, and volunteers as additional insureds. The requesting organization hereby agrees to indemnify, defend and hold harmless the Whitehall Township Public Library, its board members, employees and volunteers from any and all liability, claims and damages (including personal injury) as a result of use of the library.
  • Statement of Responsibility:

  • I have read the Policy for Meeting Room Rental for the Whitehall Township Public Library and agree to abide by its rules. I understand that our group shall assume financial responsibility for any equipment, rental, clean up, damages or extra fees. I understand that we will be responsible for our group and its guests while using the library’s facilities. I agree to report any injury or accident occurring on the premises. I agree to abide by these and all other terms and conditions as set forth in the Whitehall Township Public Library Meeting Room Policy and hereby acknowledge receipt of a copy of the Policy for Meeting Room Rental and Emergency Procedures.
  • Date Format: MM slash DD slash YYYY