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Request a purifier

Hi!! Thanks!!! Please check the calendar before filling out this form (at least 1 week prior to your event if possible). Your request is not confirmed until you receive a confirmation text/email. Please allow 1 week for a response.
You can message nervousrituals.22 on Signal or email [email protected] if you have any questions :)

Your name

(and pronouns if you want)

Event date

The entire time you'll need the purifier for.

Ex. My event is 6-9pm, so I'll need it 7-10pm.

Transportation

- You will be responsible for picking up the purifiers from me prior to your event + returning them to me afterward (unless you need an accessibility accommodation).
- If your event ends after 7 PM, plan on returning purifiers the following day.
- Please write down the times you choose & remember them! :')

What dates/times can you pick up & return the purifier(s)?

This can be adjusted later, but it helps me schedule. Please save this info for your records.

Pickup date

Pickup time

Return date

Return time

I want to borrow...

More detailed info on each found here!
I want to borrow...

Preferred way to be contacted

Preferred way to be contacted
A
B
C
D

Phone number or Signal username

Email

Accessibility

Check the boxes below that apply to you. This will not impact your booking, it just helps me arrange logistics. Please only select "I don't have access to a vehicle for transport" if you've already exhausted all other potential transport options with friends/comrades/etc.

For reference:
- Luggable XXLs, Luggable XL Ultra - 10lbs, has a handle, 25" L x 25" H x 7" W.
- Smart Air S - 10 lbs, no handle, 13" x 13" x 14.3".
- Westinghouse 1408 - 5lbs, has a handle, 6.3"L x 6.3"W x 3.5"H.
Accessibility

Please read the equipment lease agreement carefully, and when you're done, type your name to sign the contract.

Public event details (optional! skip if private)

This info will be added to the Covid Safer Oly calendar!

Please tell me what your event is & include accessibility info to the best of your ability.

Ex: Event title at Venue (address), 7pm-10pm, $10 NOTAFLOF, all ages, masks required. ADA accessible, air purifiers. No stairs into venue, street level, gender neutral restroom with grab bars.

Is this event masks required? Please do not select "yes" if it is only masks recommended/encouraged.

Is this event masks required? Please do not select "yes" if it is only masks recommended/encouraged.
A
B
C

If your event is masks required & involves food, how will that be handled?

If masks are provided, what type?

Instagram handle if applicable (for event promotion)

- Tag @cleanairoly on your event post so more people can discover + utilize this resource & I can cross-promote! - Feel free to download the logo for graphics/flyers. - PLEASE add "masks required" and/or "air purifiers" to your flyer (if applicable) so people know what to expect!!

Do you need masks for your event?

If yes, how many? Preferred type? - KN95, N95, kids, etc. No guarantees, but if I have masks on hand I'll have them ready with your pickup. Check out Mask Bloc Olympia if I can't accommodate yr request!

Out of curiosity, how did you hear about this service?

Anything else you'd like to add?