The #BreathingRoom Space Request Form
Breathing Room 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. 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

Breathing Room is home to a friendly medium-sized dog, Nima, who is a beloved part of our tribe and great with people, children, and other animals. Please let us know of any allergy concerns associated with your event. We are happy to secure her upstairs in our residential quad during your event. Please be mindful of keeping the gate to the yard closed when Nima is present downstairs.

Breathing Room 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.
Primary Contact *
Your answer
Organization, Group, or Collective Affiliation
Your answer
Best Phone Number *
Your answer
Best Email *
Your answer
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 *
Your answer
Proposed Date of Event *
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Proposed Start Time *
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Proposed End Time *
Time
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Load-In/Set-Up Time *
Time
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Alternative Date *
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If your request spans multiple days, please specify below
Your answer
Brief Description of Event *
Your answer
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 *
Your answer
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?
Do you agree to our Brave Space Agreements, including resolving conflict without calling police? *
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
How many people do you hope will attend? *
Your answer
How many chairs will you need? *
Your answer
How many tables will you need? *
Your answer
Do you need sound? *
Describe your ideal spatial configuration.
Your answer
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 *
Your answer
Space guidelines & checklist
→ The first floor is fully functional & available for use. The second floor is still under construction. Please limit traffic upstairs unless we've agreed to specific use of rooms.

→ The rear half of upstairs is the residential quad, and should only be accessed by Key Holders. Doors are usually locked, but if not, please do not enter the residential quad without an invitation.

→ Please do not feed the dog, Nima, without checking in with her dad, Malik. If she is inside the space, please do not let her out into the yard unless a Breathing Room Space Steward is outside the entire time. She has escaped the yard three times and been hit by a car one of those times. We want to keep her safe.

→ The dishwasher is not yet functional.

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

→ Cleaning supplies are on the floor beneath the shelving unit in the Kitchen Pantry

CLOSING PROCEDURE

؄ Have a buddy review & complete this checklist with you
؄ 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
؄ Side door locks when closed! Make sure you have everything before you exit
؄ Lock gate with padlock & chain
؄ Report any damage or injury that occurred during your stay
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.
Your answer
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