Application Today's Date MM slash DD slash YYYY NameBusiness/Ministry Name:Street Address Street Address City State ZIP / Postal Code PhoneEmail Address: Are you a regular Well Ministry participant? Yes No If no, list Well Sposnor:Date of event MM slash DD slash YYYY Event Start Time: Hours : Minutes AM PM AM/PM Time AM PM Event End Time: Hours : Minutes AM PM AM/PM Time AM PM Description of Event (please list all specifics):Are children (12 and under) part of your event? Yes No Preferred Rooms Main Classroom / Kitchenette Middle Classroom The Well Property in its entirety Playground Children's Room Patio Please read all Terms, Guidelines, Policies & Procedures carefully before proceeding with your application. The Well - Building and Campus Use Guidelines × General Guidelines The conduct of each person in attendance is expected to be respectful of the building and/or campus, maintaining noise levels that respect others in adjoining spaces in use and adjoining properties (i.e., our neighbors). Activities and programs are limited to the approved space requested in the application. Smoking, vaping, alcoholic beverages, illegal substances or marijuana are not permitted on The Well's campus. Use of candles is strictly prohibited. The requesting individual/group is expected to leave the building and/or campus in the same condition it was prior to the event and must remove all items associated with their program immediately following the event. Furniture and table/counter items can be re-arranged but must be returned to their original set up (suggested: take a picture BEFORE rearranging anything on the floor or on the tables/counters). When children are in attendance, they must be under the control of an adult at all times and are not permitted to roam freely on The Well campus. Regarding decorations: Nothing may be tacked or nailed/screwed into the walls, woodwork, or fixtures. Scotch/Duct tape IS NOT to be used on the walls, ceiling or any other area that may leave unwanted marks or damage. Painter's tape is acceptable for use. The requesting individual/group assumes responsibility for the costs of damage, repair and/or replacement of any equipment, furniture or appliances. Selling merchandise or charging admission must be consistent with state and local regulations. There will be no construction inside the building or on the campus. Important: Willful violation of any guidelines will lead to immediate revocation of The Well's application approval. Disclaimers Either party may cancel at least 5 days prior to the use during regular business hours in writing (email). Use of the building and/or campus is on a first-come, first-serve basis. All space and items needed must be listed on the original application form. If your needs change, please contact the staff. Please note – we cannot guarantee that any additional request will be honored. Each requesting individual/group must be sponsored by a member of The Well. The requesting individual/group is responsible for the observance of the Building and Campus Use Guidelines and for cleanup. Use of the building does not include supplies. Acknowledgment To the best of my knowledge, the purpose for which I am requesting use of The Well's building and/or campus will not contradict its statement of faith, and I commit to promptly disclose any potential conflict for which I am aware or become aware of to The Well staff. I understand that The Well does not allow its building and/or campus to be generally available to the public, and that I must submit an application. CERTIFICATE OF LIABILITY INSURANCE: I acknowledge that approval or denial of this request is at the sole discretion of The Well.(Required) Check Box IF you have, and will provide, a Certificate of Liability listing The Well Training Ministry as an additional insured (to be provided upon approval of event).I acknowledge that approval or denial of this request is at the sole discretion of The Well.Signature of ApplicantThis field is hidden when viewing the formRequest Received Date MM slash DD slash YYYY This field is hidden when viewing the formRequest Received ByCertificate Received Date MM slash DD slash YYYY This field is hidden when viewing the formApplicant Notified Date MM slash DD slash YYYY This field is hidden when viewing the formWalk-through Date MM slash DD slash YYYY This field is hidden when viewing the formCertificate Received ByThis field is hidden when viewing the formWalk-through ByThis field is hidden when viewing the formApplicant Notified ByThis field is hidden when viewing the formCalendar Added ByThis field is hidden when viewing the formRequest Status Approved Denied This field is hidden when viewing the formCalendar Added Date MM slash DD slash YYYY CompanyThis field is for validation purposes and should be left unchanged.
