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Meeting Room & Facility Request

2. MEETING ROOM AND FACILITY REQUEST FORM
   Requests are not approved until you receive confirmation from the Department of Administration. All reservations require a $50.00 deposit check made payable to the City of Fishers. Applicant must provide 48 hour notice of cancellation, or the $50.00 deposit will be forfeited. For questions contact Diana Darnell at (317) 595-3111.

   Requests are not approved until you receive confirmation from the Department of Administration. All reservations require a $50.00 deposit check made payable to the City of Fishers. Applicant must provide 48 hour notice of cancellation, or the $50.00 deposit will be forfeited. For questions contact Diana Darnell at (317) 595-3111.

4. Please check the requested room:

   1. City Hall Auditorium (capacity 150)
   2. Central Conference Room (capacity 15)
   3. Foyer Conference Room (capacity 14)
   4. Pavilion (capacity 25)

6. Organization (if applicable):

8. Contact Person:

9. Email:

11. Phone:

12. Fax:

14. Street Address:

16. City:

17. State:

18. Zip:

20. Number of Participants:

22. Requested Dates:

23. Requested Times (Starting and Ending):

    Time requested must include preparation and cleanup.

25. Please provide set-up instructions/other information here:

    Please call (317) 595-3475 to contact Building Maintenance if problems arise during your meeting. Doors will not unlock until 15 minutes prior to the meeting start time. Do not call Building Maintenance before this time.

27. Waiver

    In consideration of the use of a City of Fishers facility, I hereby waive, release, and discharge any and all claims for damages, death, personal injury, or property damage which I may have, or which hereafter accrue to me as a result of my use of the facility. This release is intended to discharge in advance the City of Fishers, the City Council, its officers, agents and employees from and against any and all liability arising out of or connected with the use of said facility. It is understood by checking the box below that I have agreed that this waiver, release and assumption of risk is to be binding on my heirs, personal representatives, next of kin, spouse, and assigns. I agree to abide fully by the City of Fishers Meeting Room & Facility Use Policy, which I may request a copy of at any time. I further agree that I will be responsible for any and all damages caused by my group to the City's facility. Checking the box below indicates the requesting group or individual is in agreement with all City of Fishers facility use procedures and the participation waiver.

    1. I Agree
29. Electronic Signature

    By checking the box below and hitting submit you are acknowledging your agreement with the terms stated in this application and further certifying that checking the box counts as an electronic signature. Your electronic signature is considered legally binding the same as signing your physical signature by hand (IC 26-2-8).

    1. I Agree
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

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