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<br />Application! Agreement <br />for use of <br />Centerville City Hall Council Chambers <br /> <br />Purpose for which facility will be used <br /> <br />Hours of use from: <br /> <br />to: <br /> <br />Date: <br /> <br />Organization <br /> <br />Mailing Address <br /> <br />City <br /> <br />Zip Code <br /> <br />Phone <br /> <br />Contact Person <br /> <br />Contact Person Home Phone: <br /> <br />Business Phone: <br /> <br />. <br /> <br />The above applicant, its agents, employees and members: <br /> <br />.. <br />; '. <br /> <br />1. <br /> <br />Agree to indemnify, defend and hold the City harmless from and against any <br />damage, liability or claim of any person or entity for injury to person or property or <br />death arising in any way out of the use of the facUity by the applicant, his or its <br />officers, directors, guests, members, 'employees, agents or assignees. <br /> <br />2. <br /> <br />Agree the City shall not be liable for damage to the property of any person or entity <br />participating in the activities applied for herein, nor shall it be liable for the death <br />or injury of any such person or entity occurring as a result of the use of the facilities <br />as applied for herein. <br /> <br />3. <br /> <br />Agree to pay for all damages to City property or equipment over and above normal <br />wear and tear. <br /> <br />4. <br /> <br />Assumes full responsibUity for the conduct of the group during the time this facility <br />is being used. <br /> <br />19 <br />