Booking Form

St. Alban’s PCC HApplication for Hire of the Eccles Hall

(home of the Earsdon community project)

PLEASE NOTE A BOOKING IS NOT CONFIRMED UNTIL YOU HAVE RECEIVED CONFIRMATION IN WRITING OR BY E-MAIL

 

Name of hiring organisation or individual: ………………………………………………………………….….

What does the organisation do?: ……………………..………………………….………………

Will the booking be one off /regular weekly/fortnightly/monthly/termly *   *(Delete as appropriate)

Date(s) and time(s) of booking(s) required:

 

Organisation contact person:  Name …………………………………………………..………..

Address ………………………………………………..……….……………………………………

Phone number: Daytime……………………….….……..Evening………..……..…………….

Email: ………………………………………………………

Is the organisation insured for the proposed activities?  Yes/No

If Yes name of insurer……….……………...….. Amount of liability covered £…………………..

Insurance Policy Number …………………………..

N.B. It will be necessary to produce a copy of the insurance certificate for the Hall Secretary/Administrator before a booking can be confirmed.

Does the Organisation work with under 18s?  Yes /No

If ‘Yes’ Does the Organisation have a Child Protection Policy?  Yes/No

N.B. It will be necessary to produce a copy of this Policy to the Hall Secretary / Administrator before a booking can be confirmed. Bookings will not be accepted for those working with children unless the organisation has such a policy or adopts and implements the Church’s Child Protection Policy.

Are those leading the activity properly vetted in relation to child protection including CRB checks etc?  Yes/No

Does the organisation sell food (other than light refreshments) Yes/No

Have those preparing the food obtained necessary qualifications under the Health and Hygiene Legislation?  Yes/No

Please note that while St. Alban’s PCC (as owners of the Eccles Hall) make every effort to ensure the safety of all who use its premises, your organisation will be solely responsible for both premises, personnel and its activities during the period of your booking.

I make application for the use of the premises as set out above and agree to abide by the Regulations and Conditions of Hire, a copy of which I have received and read (delete if not applicable)

On behalf of my organisation I accept liability for the property, personnel using the property and all activities during the period or the booking.

Signed: ………………………………………………

Date:………………………………………………….


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