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City Hall Conference Room Use Application and Agreement

2. Date of Event*
   Date of Event Start Date

   Date of Event Start Time

   —

   Date of Event End Date

   Date of Event End Time
4. Organization Name*
6. Organization Mailing Address*
8. Requestor First Name*
9. Requestor Last Name*
11. Phone Number
13. Email Address*
15. Secondary Contact Person Name and Phone Number
    If there is another person we should contact in the event we can't reach the primary requestor their name and phone # should be listed.
17. Total # of Adults *
18. Total # of Children*
20. Will Refreshments/Food be Served?*

    Please check all that apply

    1. Food
    2. Beverages
    3. Items for sale **
    4. None of the above
22. ** If there are items for sale, a Snoqualmie Business License must be obtained and presented to the Administrative Staff prior to your event.
24. Meeting Facility Guidelines and Information
    Guidelines and Information
26. INSURANCE REQUIREMENTS - The City may require liability insurance for use of this facility. If determined so, the City will require insurance and proof of insurance in the form of a Certificate of Insurance naming the City of Snoqualmie as an additional insured. Insurance amounts for use of the premises will be for $1 million general liability coverage each occurrence and $2 million general aggregate. Organizations may have Commercial Liability Insurance or may obtain insurance from the Washington Cities Insurance Authority (WCIA) for certain events. The WCIA may be contacted at www.wciapool.org, phone (206) 575-6046 or Fax (206) 575-7426. The certificate must be submitted to us a minimum of seven (7) days prior to the event date.
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit Submit and Print

* indicates a required field