Space Rental Application

COMPLETION AND PRESENTATION OF THIS APPLICATION DOES NOT GUARANTEE THAT A SPACE RENTAL AGREEMENT WILL BE ISSUED FOR THE DESCRIBED EVENT.

The undersigned, hereinafter referred to as the applicant, hereby makes application for permission to use portions of Senior Services’ Intergenerational Center for Arts and Wellness as noted below, on the date(s) requested for the specific purposes indicated. In the event of conflicting applications, Senior Services reserves the right to select the event to be presented in the facility. Senior Services will make every effort to accommodate all events which align with the purpose of the Generations Center. This application must be reviewed and processed before a space rental agreement can be prepared for an event.

Your Contact Information

Organization Name: *

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Email Address *

Work Phone Number:

Mobile Phone Number:

Event and Reservation Details

Formal Name of Event: *

Type of Event: *

Type of Event (Other): *

Date of Event: * +

Event Start Time: *

Event End Time: *

Brief Description of the Purpose of the Event (include how your organization/event's purpose aligns with that of the Generations Center): *

Aprox. Number of Attendees: *

Please select the space(s) you are requesting to reserve: *

Please provide the dates and times that you will need to reserve and access the space for event set up and event break down: *

	Event Set-Up	Event Break-Down
Date(s)	Event Set-Up	Event Break-Down
Time (start and end times)	Event Set-Up	Event Break-Down

Please attach additional documentation or collateral material that would be helpful in evaluating the event application.

Liability Insurance Information

It is required that entities reserving space at the Generations Center have liability insurance. Please provide information regarding your coverage below.

I certify that my organization has liability insurance consistent with levels required. (check box) *

I agree

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address

Acknowledgement and Attestation

The information listed in this application is complete and accurately presented to the best of my knowledge, and I have read and understand the Facility Rental Rates and Guidelines document available on the Generations Center website. *

clear

Re-Affirm by Typing Name: *

* +