Form Center

Library Conference Room Request Form

Requested Room*
1. Large Conference Room (Available 6:00 AM - 10:00 PM)
2. Small Conference Room (Available only during library open hours)
Will you need to use the ceiling projector?*
1. Yes
2. No
Please note that meeting room requests for dates from January to May 2022 will not be approved until December 2021 at the earliest.
Meeting Date*
Meeting Date
Meeting Time*
Meeting Time Start Time
—
Meeting Time End Time
Reservations for the Large Conference Room that begin or end outside of library hours must also arrange to check out a key from the front desk.
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Waiver and Release
PCPL Conference Room Policy
In exchange for use of the Library of Powhatan County, Virginia, or any of its facilities, the undersigned hereby releases the library, its agents, officers and employees, and the County of Powhatan from all liability for personal injury or property damage arising out of the use of the Library or its facilities. The undersigned hereby indemnifies and holds harmless the Library, its agents, officers and employees, and the County of Powhatan from liability and expenses, including attorneys' fees and court costs and expenses, for any and all personal injury or property damage, or both, to any person or property arising in any way out of the undersigned's use or occupancy of the Library.
Electronic Signature Agreement*
By checking the "I agree" box below, I agree and acknowledge that you have read and agree to the Rules and Regulations and have signed a waiver. I understand that this reservation is contingent on the possibility that you may have to cede the room for county government use and agree to make the reservations with full knowledge of this contingency. I have read and agree to adhere to the policies and rules of the Board of Trustees of the Powhatan County Public Library on the use of the Library Conference Rooms. I understand that improper use of the Library Conference Rooms or library furnishings will result in loss of future Conference Room use privileges.
1. I agree.
Electronic Signature

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