Name

Organisation Name (if applicable)

Email Address

Contact Number

Contact Address

Postcode

Purpose of Room Hire Purpose of Room HirePrivate MeetingCommunity EventPublic PerformanceFundraising EventBusiness OperationChildren's PartyOther

Type of booking Type of booking Personal use Charity/Not for profit Community Event Business Other

Frequency of event Frequency of event One off hire Weekly Fortnightly Monthly Other

Day of the week Day of the weekMonday MorningMonday AfternoonMonday EveningTuesday MorningTuesday AfternoonTuesday EveningWednesday MorningWednesday AfternoonWednesday EveningThursday MorningThursday AfternoonThursday EveningFriday MorningFriday AfternoonFriday EveningSaturday MorningSaturday AfternoonSaturday EveningSunday AfternoonSunday Evening

Start Time - including set up

Date of Event or Start Date if repeat booking

Finish Time - including clear up

Which Room(s) do you wish to book? Which Room(s) do you wish to book? Church Hall Worship Space Meeting Room Children's Party Package Weekend Evening Event Kitchen Office Not sure, need to discuss requirements

Do you have your own insurance? Do you have your own insurance? Yes No

Insurance Details - if applicable

By checking this box you are indicating that you understand any safeguarding requrements relevant to your event and that it is your responsibility to ensure the relevant procedures are in place. By checking this box you are indicating that you understand any safeguarding requrements relevant to your event and that it is your responsibility to ensure the relevant procedures are in place. I confirm relevant Safeguarding procedures are understood and in place Safeguarding requirements are not applicable to this event

Do you wish to serve alcoholic drinks? Do you wish to serve alcoholic drinks?NoNo, but people may bring their own alcoholYes - free to guests without an admission chargeYes - included in the admission chargeYes - available for a donationYes - sold at the event

Does your event involve outside contractors? Does your event involve outside contractors?NoCatererDJLive MusicBouncy Castle/Children's EntertainerOther - please specify in Further Information below

Further Information

In making this application I confirm; (i) I have read and accept the summary of conditions (ii) the description of the event or activities is accurate and truthful (iii) I understand that Chorlton Central Church is not obliged to accept this application or to give any reason for refusing it (iv) I understand that neither the Church nor its officers accept any liability for loss or expense arising out of this application (v) I understand that if children are expected at this booking (except under continuous parental control) and/or vulnerable adults are expected at the booking it is my responsibility to know and to implement all applicable child protection measures including holding DBS Certificates; and that failure to produce DBS Certificates on request may result in cancellation without refund (vi) I understand that no booking exists until confirmed by the Church and that no liabiltiy is accepted for expenditure incurred in the meantime (vii) Personal Data: I understand that the Church will retain personal information contained in this application for the purposes of managing room hires but for no other purpose; and will pass this information to third parties ONLY where required by law