I	
on behalf of 
while in use on	

purpose of	

COMMUNITY ROOM USE POLICY
(Effective January 12, 2010)

A fee has been imposed for the use of the Community Room to recover cleaning costs and/or
damage repairs to the Abel F. Atencio Community Room. $20.00 - 0 to 4 hours; $25.00 - more

than 4 hours per day. A $60.00 Deposit will be required.

All groups shall be subject to the fee with the *exception of other elected governments (county,
state, federal or tribal) which must have an elected official sign assuming responsibility should
damage occur during the use of the room, and must be accompanied by a letter from the agency.

ASSUMING RESPONSIBILITY FOR IGNACIO COMMUNITY ROOM

Date of Request

Rec=d/ approved By

(Print name)

(Group or Government Agency)

do hereby assume responsibility should damage occur to the Town of Ignacio Community Room

from

to

for the

(Date)

(Time) (Time)

(Activity)

(Signature)

(Work Phone #)

(Home Phone

*Groups with a history of making grounds improvements for the Town of Ignacio in lieu of
payment may continue to use the Community Room under the same arrangements. This must be
agreed on by both parties in advance.

RULES AND REGULATIONS FOR USE OF COMMUNITY ROOM (PLEASE READ BEFORE SIGNING)

1 .

Individual signing permit is responsible for facility and conduct of the group while using

facility.

2.

Individuabs copy of the permit must be in his/her possession during the use of the facility
or else the group can be removed from the premises.

1 .

The Community Room must be left in the same condition as when you entered. (Trash,
chairs, heat, lights).

2.

Any individuals using the premises accepts the condition of the facility As isL-,-, and is fully
responsible for any such use. Furthermore, such individuals using the premises hereby,
fully release and hold harmless the Town of Ignacio for any damage or injury which may
occur during use of this facility.