Community members and organizations interested in using 5 Healthy Towns Wellness Centers for meetings or other events must complete a Facility Use Request form at least three weeks ahead of the proposed event. If your request is approved the listed contact will receive an email notification and be invited to complete the facility use agreement form. The agreement form and payment to the Wellness Center must be complete at least three weeks in advance of the event.

Wellness Center Use Request Form

Wellness Center space you're requesting to use
Consent(Required)
Organization Type
MM slash DD slash YYYY
Contact Name
MM slash DD slash YYYY
Date of first meeting. If your event is reoccurring please indicate so in the special function request box.
Room Set-up
Additional Items
Facility UserExamplesDirect Mission Relationship (required)Hourly Rate
Non-profit charitable, community service, & faith-based orgsSenior Centers, Scouts, Faith In Action, Lions CubsYesFree
Government and public agenciesPublic Health, libraries, boardsYesFree
Unincorporated groupsWalking group, garden clubYesFree
Businesses, for-profit clubs, travel sports, condo associations, etcYes$100
All facility users not previously identifiedYes5HF Discretion
EventsYes$200
Unsolicited education programs by for-profit organizationsYes$200
Unsolicited education programs by non-profit organizationsYes$100 (may be waived)