Golden Gate Center for Enrichment Programming Request
Thank you for your interest in offering free life enrichment programming to Martin County residents and beyond at House of Hope’s Golden Gate Center for Enrichment.

After submitting your form you will receive a confirmation email in 1-3 business days. Program approvals may take several weeks and the team may ask clarifying questions during the process.

Every month House of Hope “locks in” the program schedule for the upcoming month by the second Friday of the month to allow for ample time for outreach. Please factor in this monthly deadline when submitting program requests.

If you have any questions, please contact our Site Coordinator at goldengate@hohmartin.org or (772) 286-4673 x1600.

Name of organization: *
Your answer
Address:
Your answer
Website if applicable:
Your answer
Contact Person: *
Your answer
Phone: *
Your answer
Email: *
Your answer
Facilitator Name:
Your answer
Facilitator Email:
Your answer
Facilitator Phone:
Your answer
Type of Organization *
Required
Program Name: *
Your answer
Focus Area *
What language(s) will the program be offered in? *
Required
Program Description: *
Please describe the program model so House of Hope may better understand how your program will meet the mission of the Golden Gate Center for Enrichment. This description will be used internally and will not be made available to the public.
Your answer
Using only a few sentences, please write how you would like your program to be listed on the GGCE calendar. *
Your answer
Program Goals & Outcomes: *
Your answer
Program Structure: *
Ex: Class runs for 6 weeks total. No new participants after the first two classes.
Your answer
Is your program faith-based? *
Minimum & Maximum number of participants: *
Your answer
What demographic is your target audience? (Age, gender)
Male
Female
Male & Female
5-10
11-14
15-18
19-25
26-54
Seniors 55+
Open to all ages
Are there any restrictions on participants?
Ex: Age minimum/maximum; Must be Martin County resident; Child must be with parent or guardian.
Your answer
How will you recruit participants? *
Your answer
How will you be marketing your program and sharing the Golden Gate calendar in the community? *
Please check all that apply
Required
How often will you need to use the room? *
Required
Please select the preferred start date & time for your program: *
We will contact you to confirm availability of your preferred schedule.
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Start Time: *
Time
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End Time: *
Time
:
Does your program allow walk-ins or do participants need to pre-register? *
Will you need any of the following? *
Please note, it is your responsibility to set up the room to best meet your needs. Please plan to arrive early to set up.
Required
Is there anything else we should know about your program?
Your answer
Insurance and Liability Information
Each organization or individual that offers a program or service at the Golden Gate Center for Enrichment must sign an MOU with House of Hope.

Our liability and insurance requirements are described in the MOU as the following:

“Partner Agency shall defend and indemnify HOH, its successors and assigns, officers, directors, employees, andsupervisory volunteers, (collectively, “Indemnified Parties”) from and against all third party claims, actions, suits,demands, damages, obligations, losses, settlements, judgments, costs and expenses (including without limitationreasonable attorneys’ fees and costs) (“Claims”) which arise out of or relate to (1) death or bodily injury or (2) loss ofor damage to real property resulting from any negligent act or willful misconduct of Partner Agency except to theextent that such Losses result from, in whole or in part, (a) the negligence, unlawful or wrongful acts of theIndemnified Parties or any other person acting in concert with them.”

The partner, at its cost, shall provide general liability coverage in the amount of One Million and No Cents ($1,000,000.00) Dollars per occurrence and Two Million and No Cents ($2,000,000.00) Dollars in the aggregate.

At the time of execution of the MOU, partner shall provide an insurance certificate in a manner or form reasonably acceptable to House of Hope, Inc. The named additional insured must include the following: Jesus House of Hope, Inc. , its successors and assigns, officers, directors, employees, and supervisory volunteers are included as additional insured and it should be sent to: Attn: Director of Operations, 2484 SE Bonita Street, Stuart, FL 34997.

The partner shall also secure Workers Compensation coverage at the statutory minimum amount whether or not the partner is required to do so by Chapter 440, Florida Statutes.

Can you meet these insurance requirements? *
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