Pitch Booking Application Form 23/24

Pitch Booking Application Form

All asterisked fields have to be completed in order to submit the form.
Section 1

To be completed by all
Name of Club / Organisation*
Registered business or club name
6-Digit Membership No. (if applicable)
ASP _ _ _ _ _ _
Name of the Applicant*

First NameLast Name
Address of the Applicant*

Street Address

Street Address Line 2

TownCounty

Post Code
Phone Number*

Area CodePhone Number
Email*
example@example.com

Section 2

To be completed by all
Purpose of Use/Activity:*
Please outline if it's training, fixture and the nature of the sports played.
What is the nature of your application (select as appropriate)*

Block Booking (continuous; weekly)Event/Specialist Booking (one-off)

Section 5

To be completed by all external applicants where applicable
If the activity is run by a tutor or coach please provide the following details:

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
Are you an individual/organisation working with children under 18 years of age?*

YesNo
Does the group operate an approved policy and procedure for the care and protection of young people under the age of 18 years of age (safeguarding)?*

YesNo
Please provide relevant Safeguarding Policy documentation

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Appointed Safeguarding Officer Full Name:

First NameLast Name
DBS Form Reference:
Date of Birth:

DayMonthYear
Date
Appointed Safeguarding Officer's Declaration

I confirm that all staff under my supervision have completed an enhanced DBS with barred list check and have a legal Right to Work in the United Kingdom.
Please provide 'Letter of Assurance' (optional)

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Do you hold a Public Liability Insurance?*

YesNo
Please provide relevant PLI documentation (optional)

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If you are a sports club or organisation, do you hold a National Governing Body accreditation award?*

YesNo
Please provide relevant documentation

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Section 5a

To be completed by all
Adults (18 or over)*
Estimated number of participants attending
Juniors (Under 18)*
Estimated number of participants attending
Is the individual/group profit making?*

YesNo
Please provide fee details:
per person/session
Please Note: Individuals or Groups who charge class/course fees may be requested to provide audited accounts for verification purposes.

Pitch Booking Application Form