Use Agreement, Waiver and Indemnification Form for Tools and Equipment

Philmont Public Library
101 Main Street
Philmont, NY 12565

Tools and equipment borrowed from the Philmont Public Library are for use by patrons with a
valid card in good standing from any MHLS member library.
I, ______________________ (print name), state that I am capable and
sufficiently experienced in using the tools and equipment I am borrowing, that I will use all
items I am borrowing in a proper and safe manner, and that I will not allow any other person(s)
to use the tools and equipment that I am borrowing without my careful supervision.
I, ______________________ (print name), do hereby for myself, on behalf of my
successors and assigns, in consideration of being permitted to borrow tools and equipment,
waive any and all claims, demands, actions, and causes of action against and agree to release,
indemnify and hold harmless the Philmont Public Library, its trustees, directors, employees and
agents from and against any and all liability, loss, claims, and demands, actions or causes of
action for the death of or injury to myself or any other person(s), and from and against any
property damage or damages of any nature suffered, incurred, or caused by myself or any other
person(s) which arises or may arise or be occasioned in any way from the use or misuse of tools
and equipment I am borrowing from the Philmont Public Library. I am aware that the Philmont
Public Library, its trustees, directors, employees and agents claim no expertise and make no
representations or warranties concerning the fitness of any tool or equipment for any particular
use.
I, _____________________ (print name), agree to pay a refundable deposit of
$15 for tools or equipment whose replacement cost is between $30.00 and $50, and $25 for
those with a replacement cost over $50.00.
I affirm that I have read and fully understand both the Philmont Public Library’s “Use of Tools
and Equipment” policy and this Use Agreement, Waiver and Indemnification Form. I understand
that failure to comply with any of these rules may result in suspension or revocation of my
borrowing privileges and/or legal action against me. I hereby relinquish any and all claims,
demands, actions, and causes of action against Philmont Public Library, its trustees, directors,
employees and agents.
Name (print) __________________________________________
Signature _____________________ Date ___________________