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Use of the Ipswich Town Hall Facility

  1. Section I
  2. Section II
  3. Requested Facility / Specific Area(s)
  4. Will refreshments be served?
  5. Board of Health approval needed?
  6. By signing this application, the person whose signature appears below signifies that he/she is personally, financially responsible for their group, will see that the facilities and equipment are not misused, that groups have proper adult supervision, that properties are used in conformity with policies established by the Town of Ipswich, and that any damages and/or loss whatsoever as a result of the group’s use of properties will be compensated in full by the responsible person, upon demand.

    It is hereby understood by the responsible person signing this application that any town activities have absolute priority for use of any portion of the building, even if an outside group (e.g., the applicant) has requested the use of a portion of the building for several weeks. Any Town activity whatsoever that may be subsequently scheduled shall have absolute priority for use of the building and/or use of any of its rooms.

    The Town of Ipswich disclaims liability for loss or damage to personal property or personal injury, and the applicant individually and on behalf of each member of his/her group agrees to release and hold harmless the Town of Ipswich officials and employees and not to sue any of the same for any such liability or loss.

    I hereby personally accept on behalf of the sponsoring organization all financial responsibility for any and all damages to equipment and/or facilities and all resulting cost of any nature whatsoever.
  7. Section III
  8. Who is using the space?
  9. Additional instructions and layout map may be attached.
  10. Check or money order made out to the Town of Ipswich.
  11. Site Supervisor
  12. Equipment Use Approved
  13. Merchandise Sale Approved
  14. Refreshments Approved
  15. Leave This Blank:

  16. This field is not part of the form submission.