Details of the Hirer

​

Full Name:

​

​

If this is not a private function, please give details of the organisation which the hirer represents:

Title of Organisation

​

Address of Organisation including full Post Code:

​

​

​

​

​

​

​

​

Daytime Telephone Number:

​

​

Evening Telephone Number:

​

​

Email Address:

​

​

Are you a Charity? Yes/No

​

​

If so, please state your charity registration Number:

​

​

Are you a resident of Lytchett Minster & Upton? Yes/No

​

​

Is a Bar required? Yes/No

​

​

Is a licence required? Yes/No

​

​

Details of the booking:

​

Brief Description of the event / activities to be undertaken

​

​

​

​

​

​

Number of People Expected:

​

​

Facilities Required: Large Hall / Small Hall, Kitchen

​

​

Date Required:

​

​

Time Required:

​

​

Start:

​

​

Finish:

​

Declaration:

I declare that I have read the booking policy and agree to be bound by the Booking Policy terms.

​

Signature:

​

​

​

​

Print Name: 

​

​

​

Date:

​

Please make all cheques payable to LUCA Hall Account and crossed A/C payee

Please return the completed booking form along with your deposit of £50

​

​