East Ayrshire Council: Application For Use Of Education Premises

* Please note all fields marked with an asterisk are required to be filled in before the form will be sent.

Application For Use Of Education Premises

1. Preferred Establishment	*
2. Name of Group or Organisation	*
3. Name of Lessee	*
Contact Telephone Number	*
Contact E-mail Address

4. Contact Details
Invoice to be Sent to:
Name	*
Address	*

Postcode	*

Let Confirmation to be Sent to:
Name	*
Address	*

Postcode	*

5. Regular Let
Regular Let (Please Tick) Specify Day of week (See Guidance Note 5)	Weekly	Fortnightly	Monthly

Time of let (please include any start & clear up times required) e.g. 18:35

Start:

Finish:

Letting Sessions: (please give details of dates required) e.g 08/01/2009 (See Guidance Note 5)	Day	Start Date of Let	Finish Date of Let

One-Off Let	Day	Date	Time
One-Off Let			Start:	Finish:

Additional Time Required for One-Off Let	Day	Date	Time
Additional Time Required for One-Off Let			Start:	Finish:

6. Details of Let

Purpose of Let:

Accomodation Required:

Equipment Required:

No of Tables
No of Chairs

Please specify below the layout of room, if required.

Group composition (Max Number) & Child Protection Policy:
Children Under 12 *	Young People Under 18 *	Adults *	Vulnerable Adults *
If your group conssists of Children or young people under 18, your Group must have a Childrens' Protection Policy. All leaders, coaches, helpers and employees who have regular access and/or hold a child care position must be checked with Disclosure Scotland (See Guidance Note 7).

8.Qualifications

Sports Instructors must have relevant and valid Governing Body qualifications/affiliations, and adhere to any specified ratios for the activity.

Where water based activities are being undertaken, a minimum of two qualified lifeguards must be present at the poolside at all times. Lifeguard qualifications must be verified at any Community Learning & Development office prior to any let of swimming pools being approved.

9.Health & Safety - Fire Warden:

Name of Nominated Fire Warden: (See Guidance Note 9 for further information)
*

10.Disability
Do you have special requirements relating to the needs of any members of your group with a disabilty?	Yes	No

11. Portable Appliances
Do you intend to bring in any electrical equipment? e.g. Disco Equipment, Spotlights, etc. If yes, see Guidance Note 11 for further information	Yes	No

12. Are you supplying alcohol at this let?
If yes, a liquor licence may be required. Please contact the Clerk to the Licensing Board for further advice. (See Guidance Note 12 for further information)	Yes	No

13. Declaration - Groups/Organisations:

I hereby make application for the use of the specified accommodation and if granted agree to accept and abide by the conditions of let and guidance notes.

Name * Date:

14. Declaration - Declaration - Individuals who deliver services in their own right:

I hereby make application for the use of the specified accomodation and if granted agree to accept and abide by the conditions of let and guidance notes. Having made all appropriate enquiries concerning if I could register with an umbrella organisation who could obtain disclosures on me, I confirm that as a sole operator/trader I am unable to obtain an enhanced disclosure in terms of the Police Act 1997 and that I have no employees paid or otherwise, and therefore will not ask any other person to act on my behalf. I also confirm that I am not listed on the Disqualified from Working with Children List established under the protection of Children (Scotland) Act 2003 or in equivalent list kept for England, Wales or Northern Ireland.

Name * Date:

Sending this form confirms that you have read and accepted the terms and conditions as laid out in East Ayrshire Council's Terms of Service.

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Guidance Note 5 Back
If you require the let on a regular basis, please indicate if you need a weekly; fortnightly or monthly let. Term times are listed as per school calendar - please enter your start date and finish date for each of the term times. If you require the let to continue to a date outwith the term time indicated, please enter the date you wish to end the let. Times: Please enter the full time required for the let. Remember to include any preparation time and also in the case of a licensed function any extra time required to remove bar.

Guidance Note 7 Back
For further information in relation to the Protection of Children (Scotland) Act 2003, please see www.scotland.gov.uk/childprotection For further information in relation to whether you require a Disclosure Scotland check, please access: www.disclosurescotland.co.uk The Council supports safe and supportive environments for children, young people and those working with them, and, to encourage this will make information available on the Protection of Children (Scotland) Act 2003 and what to expect in terms of Good Practice, to parents/carers using our halls and premises, as well as to groups who provide those services.

Guidance Note 9 Back
A Fire Warden must be nominated for the let. This person is responsible for the register of attendees and evacuation of the group should there be a requirement. You may be asked to provide a copy of your evacuation procedure.

Guidance Note 11 Back
Please indicate if any electrical equipment will be brought in for use within the area of let by the group/organisation. The Janitor or agent on site/Centre Supervisor will have the authority to check that any electrical equipment has a Portable Appliance Testing Information label attached. All equipment should comply with BS 7671. Any item which does not have a current PAT Label cannot be used in council premises.

Guidance Note 12 Back
A liquor licence may be required if you are supplying alcohol. This can be applied for and advice sought from: - The Clerk to the Licensing Board, East Ayrshire Council, London Road HQ, Kilmarnock, KA3 7BU. (01563-576005) The Licence must be shown to our Agent on site and put on display during the let.

APPLICATION FOR USE OF EDUCATIONAL PREMISES