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APPLICATION FOR ELK RIVER PUBLIC LIBRARY COMMUNITY ROOM <br /> Organization Name <br /> Contact Name <br /> Address City Zip <br /> Phone Email <br /> Activity <br /> Date Requested Number of People Expected <br /> Start Time(includes set up) End Time(includes clean up) <br /> By signing this application, I acknowledge receipt of and agree to follow the Elk River Public Library <br /> Community Room Use Policy. I understand that a portion or all of my deposit may not be returned if these <br /> policies are not followed. I authorize the City of Elk River to file a claim against my insurance company if <br /> the deposit I have given does not cover any damages or cleaning needs required from my use of this facility. <br /> I understand I will be the first one in the room and the last one to leave from my group and I must be <br /> present during the entire event. <br /> Signature as Permit Holder Date <br /> For Offrce Use Only <br /> Date deposit received Payment: ❑Cash ❑ Check# ❑ Credit Card ❑ Money Order <br /> Visa/Mastercard # - - Expires <br /> Name as it appears on card <br />