Meeting Room Reservation Form

If you have questions, please call Bethann Ford at 804-966-2480 x106.

The meeting area is available 15 minutes after the library opens until 15 minutes before closing. This includes set up and tear down time.

Please check the room location you wish to reserve: *10790 Courthouse Road, Charles City, VA 23030 (804) 652-24507791 Invicta Lane, New Kent, VA 23124 804-966-2480 (Fax 804-966-5982)

Organization/Company Name *

Street Address *

City

State

Phone Number *

Fax Number

Contact Email Address

Contant Name/Title *

Alternate Contact

Alternate Contact Email Address

Meeting Date *

Beginning and Ending Time *

Purpose of Meeting

Anticipated # of attendees

Non-Profit Organization? *YesNo

For Profit use fee $100(to be filled in by approving staff member)

Terms and Conditions

By reserving a room, you agree to the following:

I agree that my event/meeting is free.
I agree that my event/meeting is not a social gathering, including but not limited to , birthday parties, showers and family reunions.
I agree not to exchange money for admission, participation, donations, fundraising or commercial goods or services
I understand that room setup, including arrangement of tables and chairs, is my responsibility, and must be completed after my reserved start time.
I understand that the room must be returned to its original condition before the end time of my reservation
I agree not to store equipment or supplies in rooms.
I agree not to have any open flames
I agree not to serve alcoholic beverages
I agree that publicity or promotion for my event/meeting may not imply sponsorship by Heritage Public Library. Publicity may include the address of the facility. Publicity may not include library contact information or logos.
I agree that I only have one account/email address to book rooms.

I have read the Library Meeting Room Policy and agree to the following:

I am over 21 and will be in attendance for all of the meeting when my organization uses the meeting area.
I will be responsible for setting up and taking down any furnishings needed for the event.
I will be responsible for a topical cleaning of the meeting area when our meeting is over and leave the room/area in the condition in which it was found.
I will be responsible for costs associated with extra cleaning if necessary.
I will be responsible for costs incurred by damage to the library or the meeting room during use by my organization.
I will take an accurate count of people attending the meeting and record it on the form kept in the meeting room for this purpose.
I have read and agree to all other rules of use for the specific area I am reserving
If our meeting is cancelled we will notify the library as soon as possible.

Acceptance of the above terms and conditions. *

Yes, I agree with the above terms and conditions and I have read the Library Meeting Room Policy.

You will receive a confirmation email when approved by the Director of the Library.

Please do not call the library to cancel your reservation. Email bford@heritagepubliclibrary.org 24 hours prior to the reservation to notify us of your cancellation.

Date Submitted: 06/17/2025

For Staff Use: Approved by:
Date:

Meeting Room Calendar checked by:
Date:

Confirmation sent by:
Date: