Kitchen Rental Application - Island of Hawaii YMCA

Fee Schedule

$50.00 General YMCA Membership (one-time only)
$50.00 Authorized Signature for Department of Health Support Kitchen Use Agreement (YMCA CEO)
$25.00 / hour Wastewater Disposal Fee
$15.00 / per hour Kitchen Preparation
$20.00 / per hour Kitchen Appliances (usage of Oven, Stove, Refrigeration, Electricity)

Business Name*

Applicant Name*

Are you a YMCA Member?*

Yes

Mailing Address*

Physical Address*

Email*

Phone*

Food Product*

Location of Distribution*

Distribution Dates*

Referred By

Purpose for Rental*

Dept. of Health Agent Contact Name

Agent Phone

Business Type*

Non-Profit

Profit

Other

Food Truck*

Yes

Food Truck Location

Requested Certified Kitchen Co-Op Dates*

Date

Day

Time

Purpose

Kitchen Use or Wastewater Disposal?

General Rules & Consent

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.

Certified Kitchen Co-Op Application

Fee Schedule

General Rules & Consent

Hawaii Dept. of Health Food Safety and Sanitation Guidelines

Member Portal