Booking Form for use of premises

Name of Organisation:*
Contact Name:*
Telephone no(s):*
E-mail address:
Name and contact details of person in charge on the day if different from above:
Dates and times required:*
Rooms required:*
Description of proposed activity:*
Does your activity involve children under 18?:*	Yes No
If yes, does your organisation have a Child Protection Policy in line with the Government's guidelines?:	Yes No
Is your organisation a Registered Charity:*	Yes No
Do you have Public Liability Insurance?:*	Yes No
Equipment required:*
I have read and accept the 'Conditions for Use of the Premises':*	I agree
Name:*
Date:*
Please enter the verification number on the right:*
* Required Fields