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Application/Agreement <br /> for use of <br /> Centerville City Hall Council Chambers <br /> Purpose for which facility will be used <br /> Hours of use from: to: <br /> Date: <br /> Organization <br /> Mailing Address <br /> City Zip Code <br /> Phone <br /> Contact Person <br /> Contact Person Home Phone: Business Phone: <br /> The above applicant, its agents, employees and members: <br /> 1. 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 facility by the applicant, his or its <br /> officers, directors, guests, members, employees, agents or assignees. <br /> 2. 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 /> 3. Agree to pay for all damages to City property or equipment over and above normal <br /> wear and tear. <br /> 4. Assumes full responsibility for the conduct of the group during the time this facility <br /> is being used. <br /> 5. Understands that the City of Centerville reserves the right to exercise the <br /> supervisory authority and to prevent unauthorized or illegal activities on City <br />