#BreathingRoom Campus Space Request Form
The #BreathingRoom Space is an arts, healing, and organizing hub operated by the #LetUsBreathe Collective. A small group of volunteers makes the space available at little or no cost to folks doing work or hosting events in alignment with our mission and vision.

In order to make access to the space as equitable as possible, we review and approve requests once or twice a week at our team gatherings with a collective consent model. In order for a request to be approved, two Space Stewards must be available to open and close the space. To help expand our capacity to make the space available, you can become a part of our stewardship circle by attending an orientation and participating in other Breathing Room programming as your capacity allows.

The #BreathingRoom Space, Gardens & Farm is not officially ADA accessible, but has accommodated wheelchairs in the past. Please visit the space in advance of your event if you have accessibility concerns that we can collaborate with you to address.

If you have not heard back about your request in about a week, email us at LetUsBreathe2015@gmail.com to give us a nudge - we are a small but mighty team stretching to serve our community to the best of our ability <3
Sign in to Google to save your progress. Learn more
Primary Contact *
Where will your event be?
Clear selection
Organization, Group, or Collective Affiliation
Best Phone Number *
Best Email *
Is your organization or event primarily guided by Black people or POC? *
Will your event primarily serve Black people or POC? *
Title of Proposed Event *
Proposed Date of Event *
MM
/
DD
/
YYYY
Proposed Start Time *
Time
:
Proposed End Time *
Time
:
Load-In/Set-Up Time *
Time
:
Alternative Date *
MM
/
DD
/
YYYY
Brief Description of Event *
The #LetUsBreathe Collective is an anti-capitalist abolitionist tribe, which means we prefer not to exchange money for profit and we do not call police. Do you intend to collect money for admission? *
As an anti-capitalist space, Breathing Room is intentional about how and why money is exchanged in the space. Do you intend to have vendors or other intentions to charge for goods or services? Please describe below *
The #BreathingRoom is a community resource, and its stewardship is sustained by the volunteer efforts of the #LetUsBreathe Collective, our partners, collaborators, & tribesfolk.  Can you help sustain this effort in honor of mutual exchange?
Clear selection
By entering this space:                                                                                                        * I agree to love myself and others                                                                                    * I agree to be accountable for what I do and say                                                          * I agree to struggle against racism, sexism, ageism, homophobia, transphobia, ableism, classism, misogyny, shame, and other harmful systems                                                                   * I agree to handle conflict with love and respect, and without calling police                                                                                            * I agree that my gifts bring value to this space and I receive the gifts the space offers me
Do you agree to our Brave Space Agreements, including resolving conflict without calling police? *
Do you agree to wear masks indoors and communicate that as a requirement to all who may be attending?  *
How many people do you estimate attending? (garden = 50 people max capacity, inside #BreathingRoom = 30 max capacity w/ masks) *
How many chairs will you need? *
How many tables will you need? *
Do you need sound? *
Describe your ideal spatial configuration.
We may need support with bathroom cleaning, sweeping, mopping, etc in preparation for your event. How many people will help with set-up, event staffing/facilitation, and clean-up? Please list total number of staff/volunteers, their names and roles if applicable *
Guidelines & Checklist for #BreathingRoom Space, Gardens & Farm
GARDEN & FARM DETAILS

→ Please use pathways to walk and travel through garden without damaging crops, flowers or plants.

→ Capacity: 30 people adhering to social distancing guidelines, wearing masks

→ Bathroom use available via Su Casa at 5045 S. Laflin.


SPACE DETAILS
→ The first floor is available for use, including the rear bathroom and kitchen. 

→ The front half of the second floor is also available for use. The rear half of upstairs is the residential quad, and should only be accessed by Key Holders. Guests are welcome to use bathroom on second floor. Doors to the residential quad are usually locked, but if not, please do not enter the residential quad without an invitation.

→ Please keep children and pets from walking through garden beds.

→ Cleaning supplies are available upon request.

→ Capacity: 10-15 people (on main floor) adhering to social distancing guidelines, wearing masks

CLOSING PROCEDURE

Review this checklist with a #BreathingRoom Space or Land Steward BEFORE leaving:
؄ Report any damage or injury that occurred during your stay
؄ Seal, store, or dispose of any open food
؄ Take out full trash or trash with food in it
؄ Wash any dishes you or your group used
؄ Check that all water is off
؄ Turn off all lights
؄ Turn off & unplug speaker if you used it
؄ Check bathrooms/toilets for any unusual mess (paper clogs, toilet seat hygiene, etc)
؄ Return tables & chairs how you found them
؄ Lock front door from inside & exit from side door AND/OR necessary
؄ Side door locks when closed! Make sure you have everything before you exit
؄ Lock gate with padlock & chain

Have you read and agreed to the Space Guidelines & Closing Procedure? *
We look forward to collaborating with you and building a partnership! Please describe any future plans for using the space or ways you would like to further develop our relationship.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms