Bury St Edmunds Quaker Meeting House Contacts and Declarations

Contact Details and Declarations
Name of Organisation / Individual
Contact Address

First line of address

Second line of address

Town / CityPost Code

Post Code
Name of person booking

First NameLast Name
Contact details

Phone numberEmail address
Position within Organisation
Name of person running event (if different)

First NameLast Name
Contact details

Phone numberEmail address
Name of person to send invoice to (if different)

First NameLast Name
Contact details

Phone numberEmail address
Declarations
We confirm that this is the status of the booking:

We are a businessWe are a non-profit-making organisation but this event is being funded by the Government, a local Council or the NHSWe are a non-profit-making orgaisation and this event is not being funded by the Government, a local Council or the NHS
Insurance:

We are an occasional user (no more than three times per year). We wish to be included in your insurance.We have our own insurance (and have completed the insurance declaration form below or have sent insurance documents).
We commit ourselves to the hiring agreement
Signature

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Date
Hirer's Public Liability Insurance Declaration

We confirm that we have Public Liability Insurance, which is underwritten by:
Public Liability Insurance Company
Policy Number
Renewal Date

MonthDayYear
Indemnity Limit
Employer's Liability Insurance Company
Policy Number
Renewal Date

MonthDayYear
Our insurers have been advised of our activities on your premises and we confirm to you that our insurance does cover property in our custody or control and our legal liability for any damage to your building.
Signature

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Contact Details and Declarations

Declarations

Hirer's Public Liability Insurance Declaration