Retreat Room

Lessee Full Name *

MUST BE AN INDIVIDUAL

First Name

Last Name

Date *

MM

DD

YYYY

Phone *

(###)

###

####

Start Time *

PLEASE NOTE: YOUR RESERVATION MUST ACCOUNT FOR SET-UP OR CLEAN-UP TIME NEEDED.

Hour

Minute

Second

AM PM

End Time *

PLEASE NOTE: YOUR RESERVATION MUST ACCOUNT FOR SET-UP OR CLEAN-UP TIME NEEDED.

Hour

Minute

Second

AM PM

Will food be served? *

NOTE: COFFEE, TEA AND WATER PROVIDED WITH YOUR RESERVATION.

Yes

No

Equipment: *

CHECK ALL THAT APPLY.

TV

Connecting cables

Speaker

Chairs

One-Time Reservation Terms *

BY CLICKING ON EACH CHECKBOX BELOW I AM AGREEING THAT I HAVE READ, UNDERSTOOD AND AGREE TO THE TERMS AND CONDITIONS OF THIS RESERVATION.

Reservation date and time has been confirmed with Yanira Pena.

Reservation includes use of Retreat Room with the following furnishings: 2 couches, 4 accent chairs, 2 end tables, 4 throw pillows, 1 coffee table, 1 lamp, area rug, picture frames, TV and accessories as seen in pictures below.

Reservation provides access to common area such as waiting room, coffee station and restroom.

Reservation does not allow to alter, add, replace, remove or damage any furnishings, equipment or other personal property located in, on or around the Space/Building.

Furnishings may not be removed or moved. These furnishings will remain on the premises always and will be returned in the same condition at the end of the reservation, normal wear and tear accepted.

If any damage (beyond normal wear and tear) to the Space/Building should occur during the reservation, Lessee agrees to pay reasonable repair/replacement costs.

If any damage or concerns, Lessee will notify Yanira Pena at 657-205-9571 immediately upon discovery of such damage occurring, but no later than end of reservation.

Lessee is liable for any damage caused by him/her or his/her Invitees to the Space/Building.

Lessee will be given 1 key for entry to the Space 24hrs before reservation. Key must be returned at the end of reservation.

Lessee will not make any copies of key or allow anyone else to use them. Loss of key must be reported to Yanira Pena at 657-205-9571 immediately. Lessee must pay the cost of replacement of key and or changing locks (if required).

Please help keep office space, shared amenities, waiting room and building clean by cleaning after yourself and invitees.

First 25 copies/printed pages free. 10 cents per page after that.

Normal office hours: 8am-8pm.

Wi-Fi code will be provided upon commencement of your reservation for business use only.

Entry door to remain close always; unless Lessee is present to see Invitees.

2nd Entry door from waiting room to counseling office shall always remain closed for security/privacy purposes. Lessee shall inform Invitees to use call light and remain in waiting room until Lessee comes out to get them.

Due to the nature of business, Lessee agrees to be mindful of noise and confidentiality of other Lessee’s/Lessor and Invitees in the Building.

No pets allowed. Please contact Lessor for special circumstance (i.e. pet assistant)

Payment: Complete payment via Venmo (https://venmo.com/nbcounselingtc) application (using debit card only). Reservation is confirmed with payment.

Cancellation: Reservation can be cancelled by Lessee no later than 2 weeks prior to event reservation to receive credit for future reservations.

Parking: Reservation provides access to unassigned parking spaces in structure parking/street parking for the purpose of business and client parking. Parking structure located behind the building with access point being on the first right on C St when traveling North on Main St. Nearest street parking located on B St. The Lessee shall oversee regulation and towing agreements in maintaining the parking lot.