HORTON KIRBY & SOUTH DARENTH HALLS APPLICATION FORM

JUBILEE/VILLAGE HALL   (Delete as applicable)  DATE OF HIRING……………………………….……

Name of Applicant………………………………………………………………………………..

Organisation (if any)………………………………………………………………………………

Address…………………………………………………………………………………………….

…………………………………………………………Postcode………………………………..

Telephone Numbers (incl mobile if possible)…………………………………………………….

…………………………………………………………………………………………….………

E Mail Address……………………………………………………………………………………

Purpose of Hire……………………………………………………………………………………

(if birthday party, state age)

 

Times of Hire   From ………………………………To…………………………………………..

 

Will alcohol be sold, or supplied as part of your ticket price, or provided in return for a

donation, on the premises? …………  If yes, please complete the declaration overleaf as your authorisation to do so.

 

If using professional caterers please give their name, and contact details overleaf.

 

Will a bouncy castle be used on the premises? ………     If yes, please note regulations

 

I have received a copy of the conditions of letting, including the fact that smoking is not allowed in any part of the building, which I have read and understand and agree to abide by.  I enclose a non-returnable booking deposit of £20 or 25% of the full hire charge, whichever is the greater. (Form must be signed by a person aged 18 years or over)

 

Signed………………………………………  Date……………………………….

 

Make cheques payable to : HORTON KIRBY AND SOUTH DARENTH PARISH COUNCIL

 

Any queries should be made to the Parish Office, Village Hall, Horton Road, South Darenth, DA4 9AX (01322 865193) during office hours of 9am to 12.30pm Mondays Wednesdays and Fridays or via hksdpc@tiscali.co.uk

 

Where did you hear about our hall?  Please circle as appropriate

 

Live locally /  Parish Newsletter    /  Friend or Relative    /   Dartford Living   /    Website

 

Your details will be kept for use in connection with your village hall booking only

 

 

For office use only

Cost of hire:

 

Booking deposit received…………………. Balance of fee………………… Damage Deposit………………