Small Event Application Form – under 50 people Please ensure before completing this application that you have read and understood the Box Moor Trust Conditions for Hire of Land for the Purpose of a Public Event or Function. Completing this application form does not guarantee your hire and is not considered confirmation of hire.Contact DetailsName of company or promoting organisation(Required)Company/organisation numberContact name(Required) First Last Applicant/company/organisation address(Required) Street Address Address Line 2 City County / State / Region ZIP / Postal Code Contact phone number (daytime)(Required)Contact mobile phone number(Required)Contact email address(Required) Will the above named person be the onsite contact during the event?(Required) Yes No Site contact name(Required) First Last Site contact phone number (daytime)(Required)Site contact mobile phone number(Required)Site contact email address(Required) Event DetailsType of eventExpected attendanceDescription of eventSite required for event?(Required)Blackbirds MoorOtherIf other please specify(Required)Dates and TimesProposed dates are inclusive of setup and take down.Proposed date of event(Required) Day Month Year Proposed start time of event(Required) Hours : Minutes AM PM AM/PM Proposed finish time(Required) Hours : Minutes AM PM AM/PM Will you require additional time for set up and take down of the event?(Required) Yes No If yes, please give details of your requirements.(Required)Attractions and CapacityNumber of staff on site(Required)Intended number of stalls or stands on site?(Required)If none, please record 0.Toilet facilities(Required)Depending on the size of the event, you will need to ensure there are adequate toilet facilities for your attendees. I will ensure there are adequate toilet facilities provided for the public to use during the event.Will you be using any third parties to supply goods or services at your event?(Required) Yes No Please could you provide details of the third party and what services/goods they will be supplying.(Required)Company/organisationService/goods Add RemoveVehicles On SitePlease list all of the vehicles you plan to have on site during your event.(Required)This should include all vehicle types used for transporting equipment and their weight.Vehicle typeWeightNumber of vehicles Add RemoveDo you plan to have carparking for attendees on site?(Required)Please note: you will be entirely responsible for marshalling carparking and ensuring safety of all using the site. All areas of the Box Moor Trust Estate are open access to members of the public.YesNoDocument UploadsIn order to consider your application we require a provisional site plan and provisional risk assessments. We understand these may not be complete. We make make recommendations and should we agree your application we will need final, full and complete documents 14 days before any occupation of the land.Please upload a copy of your provisional site plan.(Required)Please use the downloadable map from the website, or request a map of the area reqired.Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 128 MB.Please upload a copy of of your public liability insurance certificate.(Required)Please note you will need to have a policy of insurance against third party risks/public liability to a minimum value of £5,000,000 for any one claim.Max. file size: 128 MB.Please upload a copy of your provisional event risk assessment.(Required)Max. file size: 128 MB.Please upload a copy of your provisional event fire risk assessment, if separate.Max. file size: 128 MB.Please upload a copy of your provisional event safety plan.(Required)Max. file size: 128 MB.DeclarationsPlease ensure that you have thoroughly read and understood the Conditions of Hire document, found on our website.Declaration of authority(Required) I have the authority to apply on behalf of the company/organisation to make this applicationAgreement of charges(Required) I agree to pay all charges properly applicable to the hire of the land as specified by the Box Moor Trust. I understand I/the company or organisation will be liable for any repair or reinstatement of the land and/or the Estate caused as a direct or indirect result of our hire.Declaration of understanding(Required) I have read, understood and and agree that I, and all persons acting on behalf of the company/organisation will abide by the Box Moor Trust’s Conditions of Hire of Land for the Purpose of a Public Event or Function.