Kitchen Rental Application Certified Kitchen Co-Op Application "*" indicates required fields Business Name* Applicant Name* First Last Mailing Address* Street Address Address Line 2 City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Physical Address* Street Address Address Line 2 City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Food Product* Location of Distribution* Distribution Dates* Referred By Purpose for Rental* Dept. of Health Agent Contact Name Agent PhoneBusiness Type* Non-Profit Profit Other Food Truck* Yes No Food Truck Location Requested Certified Kitchen Co-Op Dates*DateDayTimePurpose Add RemoveGeneral Rules & ConsentAnimals* Animals: Only authorized animals are allowed on the property of Island of Hawaii YMCA.*Alcohol/Drugs* Alcohol, Drugs, Tobacco: Alcohol and drugs of any kind are NOT allowed on Island of Hawaii YMCA property. We ask that you do not promote any host, non-host bars or BYOB of alcohol on your invitations, fliers, social media marketing/advertising. Island of Hawaii YMCA also a non-smoking property. Please ensure that your guests are aware of our property rules and respect it all times. Your deposit will not be refunded to you, should we find evidence of alcohol, drugs or tobacco on the property.*Certified Kitchen* Certified Kitchen: If the use of our certified kitchen service is to prepare and/or cook for commercial or fundraising purposes, you must schedule and work with the State of Hawaii Department of Health in obtaining the State of Hawaii Department of Health-Food Safety Program Green inspection placard. Hawaii Administrative Rules Section 11-50-9 (b). We also request Kitchen rental food handlers for your event to observe the Kitchen Guidelines posted in our certification and enclosed with our agreement. Visit www.health.hawaii.gov for more information regarding How to get a Green Placard.*Clean-up* Clean-up: The applicant is responsible for the cleanup of the rented. Utilize the clean-up checklist to ensure all items on the checklist are completed and the hall and/or kitchen is returned to the same condition as it was prior to the event. Cleaning supplies will not be supplied by Island of Hawaii YMCA. The upper, lower and back gravel parking is also an area of responsibility of the applicant to clean and ensure that all debris are removed. Filled trash bags must be placed in the trash container located on the upper parking lot. Our trash container is not able to accommodate a large load of trash. Please see clean up checklist given to you upon the walk-through visit. For Kitchen Use, please utilize the 3- Compartment Sink Manual cleaning and Sanitizing of Food Equipment & Utensils.*Insurance* Event Liability Insurance: Event liability insurance may help cover expenses if you are found responsible for property damage or an injury caused during your celebration. Event liability insurance may help pay to repair damage to the venue or cover a guest's medical bills if you are found at fault. Seek for insurance options with insurance companies. Provide Island of Hawaii YMCA with your event liability insurance letter/certificate by the time of the walk-through appointment (no later than 15 business days of the event). Please report any damages or incidents to management.*Walk Through* Walk through: A required walk-through of the facility must be arranged with a YMCA staff prior to initial visit or use of kitchen*The collection of the certified Kitchen Co-Op rental application & agreement final approval will be approved by the Island of Hawaii YMCA management and/or CEO. The payment schedule is to be completed by office staff.
