Occasional Rental Request Form

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Thank you for your interest in having your event at Community Well!

In order to use our space, you must have your own General Liability Insurance. Requirements are as follows:
- General Aggregated $2,000,000
- Products-Comp/Op Agg $2,000,000
- Personal & Adv Injury $1,000,000
- Each Occurrence $1,000,000
- Fire Damage (any one fire) $300,000
- Med Exp (any one person) $5,000
You must add San Francisco Public Health Foundation/Community Well 78 Ocean Ave. SF 94112 to your General Liability Insurance as “Additional Insured.”

As long as this is possible, please fill out this form and we will get back to you. Thank you!

Email *

Full Name *

Phone number *

Title/Name of Event *

Description of Event *

Type of Event *

Holistic Health Talk or Workshop

Professional Training

Educational Workshop or Class

Social Justice Meeting or Event

Spiritual Ceremony or Discussion

Neighborhood or Community Gathering

Other:

Required

Preferred Dates and Times of Event *

Number of People Expected *

Which space do you prefer for your event? *

Will there be children in attendance? *

Yes

Maybe

Have you been to Community Well before? *

Yes

If yes, please list the classes and/or practitioner services you have attended

List any special materials or set up needed *

What is the cost, if any, for participants? *

Thank you!

A copy of your responses will be emailed to the address you provided.

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