Application for use of Agherton Parish Centre
Form 1
Organisation / Group
Name of Designated Person
*
First Name
Last Name
E-mail
*
Contact Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
Town/City
County
Postcode
We request the use of: (tick all that are applicable)
*
Main Hall (£24/hr)
Parish Room (£12/hr)
Dalriada Room (£12/hr)
Committee Room (£12/hr)
Kitchen (inc. with room hire)
Data Projector (inc. with room hire)
Church Room (£12/hr)
Church (on request)
What date would you like to book a room
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
What time will the room booking start
*
What time will the room booking end
*
Does the event repeat?
*
Yes
No
If the event repeats, please give dates and times here
Anticipated Number Attending
*
Activity/Activities Planned
*
Room Set Up: (if you require tables and chairs, please state the number of each and a brief description of the room layout)
*
Are there any participants under 18?
*
Yes
No
Are any participants vulnerable adults?
*
Yes
No
Do you intend to provide food/catering other than basic tea/coffee and snacks?
*
Yes
No
Upload a copy of your Public Liability Insurance
Browse Files
If you cannot upload your insurance information, you must leave a hard copy into the office before your booking can be confirmed and accepted.
Cancel
of
Please note:
If the room requested is not available, the Office Administrator will contact the Designated Person to reschedule. The centre will be opened approx 15mins before the booking time, if for some reason the centre is locked please call the sexton on 07545987007 for access.
Note to Administrator (if applicable)
Conditions
Conditions of Hire
Fire Emergency Evacuation Procedures
By signing below you certify that you are at least 18 years of age and have authority to make this booking on behalf of your organisation. You agree personally and on behalf of the organisation to observe and perform the conditions, provisions and stipulations contained or referred to in the Conditions of Hire and any additional Conditions of Hire appended thereto. You agree during the period of hire to supervise the event and to ensure full compliance with the terms of agreement.
*
Submit
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