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Pitch Bookings Registration Form
Hi there, please fill out and submit this form for one off or regular extended hire.
12
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1
Club Name
*
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2
Club Address
*
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Street Address
Street Address Line 2
City
County
Post Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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3
Club Contact Name
*
This field is required.
i.e. Main contact to be added to the booking system on behalf of the club.
First Name
Last Name
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4
Club Contact Email Address
*
This field is required.
I.e. Main contact email address to be added to the booking system on behalf of the club.
example@example.com
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5
Club Contact Phone Number (Mobile)
*
This field is required.
I.e. Main contact number to be added to the booking system on behalf of the club.
Please enter a valid phone number.
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6
Would you like to list any other coaches in your club who would like access to the system?
*
This field is required.
YES
NO
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7
How many additional coaches will need access?
*
This field is required.
Please Select
1 additional coach
2 additional coaches
3 additional coaches
Please Select
Please Select
1 additional coach
2 additional coaches
3 additional coaches
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8
Coach 1 - Name
*
This field is required.
First Name
Last Name
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9
Coach 1 - Email
*
This field is required.
example@example.com
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10
Coach 2 - Name
*
This field is required.
First Name
Last Name
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11
Coach 2 - Email
*
This field is required.
example@example.com
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12
Coach 3 - Name
*
This field is required.
First Name
Last Name
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13
Coach 3 - Email
*
This field is required.
example@example.com
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14
DOCUMENTATION REQUIORED PRIOR TO YOUR BOOKING COMMENCING
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15
Any organisation hiring our facilities may be required to have their own public/employee liability insurance. A copy of the insurance certificate needs to be attached to this form for your application to be considered. You may be insured under your affiliation to your governing body, if so please state, and provide documented proof.
I am required to enclose a copy of the group / organisation's Public Liability Insurance Certificate and or Employer Liability Insurance Certificate for this application.
Not Applicable
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16
PUBLIC/EMPLOYEE LIABILITY INSURANCE
*
This field is required.
Please upload a copy of the documentation required (1) Copy of Public Liability Insurance Certificate (or proof of PL insurance from Governing Body) IF APPLICABLE (2) Copy of Employer Liability Insurance Certificate (or proof of EL insurance from Governing Body) IF APPLICABLE
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: 10.6MB
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17
To hire our facilities on an extended basis it is mandatory that if your organisation is working with individuals Under 18 years of age or Adults at Risk, they have an acceptable Safeguarding Policy in place and submit this with the application. Alternatively organisation can sign up to the Council’s Safeguarding Policy and accept and apply the standards of care outlined until an organisational specific policy is submitted.
*
This field is required.
The group / organisation has its own Safeguarding Protection Policy
We would like to sign up to the ABC Safeguarding Policy
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18
Please upload a copy of your group / organisation's Safeguarding Protection Policy.
*
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Max. file size
: 10.6MB
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19
I confirm that Access NI checks have been completed for all adults associated with the club / organisation, who work with children / adults at risk on a regular basis.
*
This field is required.
Yes
No
Not Applicable
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20
Signature Approval
By signing below I agree to and am aware of: I agree to abide by the centre Code of Conduct as displayed in the centre/facility. I have received, read, understood and agree to the Terms and Conditions. I agree to supply any relevant documents requested prior to booking commencing I confirm that the details provided in this booking are correct. I agree that my booking time may be extended to cover set up and take down of equipment.
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