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Application for Alpine County Library Card Adult Non‐Resident Form Bear Valley______ Markleeville Bookmobile______ Name I am a resident and STATE, and I am in the District Permanent Addresses (Physical and Mailing) Local Residence/Mailing Address E‐mail Permanent Phone Local Cell Photo ID‐‐Specify Type (Driver’s license, Library Card, Military Card, etc.) ID I agree to accept full responsibility for all materials borrowed on this account. Likewise, I agree to abide by all Library policies and procedures and to inform staff of any changes to my contact information. Notes: OVER FOR STAFF USE ICFOF_______ Patron ID# 20251‐ ---PAGE BREAK--- Adult Internet Use Agreement I have read the Public Computer and Internet Use Policy of the Alpine County Library, and I agree to abide by the rules and policies stipulated therein. I agree to hold harmless, indemnify and defend the County of Alpine, and its officers and employees, from any claim of or legal action arising from my use of the Internet either through the library’s computers or through wireless access using my own equipment. This indemnification shall extend to the payment of reasonable attorney’s fees and litigation costs incurred by Alpine County in defense of any such claim or action. Print Name Signature Date OVER