Block booking for sport centres

Hirer name *

Club/Organisation name *

Address *

Home phone number

Mobile phone number *

Email address *

Confirm Email address *

Are the Treasurer’s details the same as the Hirer’s? *

Yes

No

Treasurer name *

Treasurer address

Treasurer home phone number

Treasurer mobile phone number *

Treasurer email address *

Activity to be undertaken *

Venue required *

Derby Arena

Springwood Leisure Centre

Space required at Derby Arena *

Whole Sports Court area

1/3 Sports Court area

2/3 Sports Court area

Sports D - end section of Sports Courts

Watt Bike Studio

Dance Studio

Meeting Room

Badminton court area

Other

Number of courts required

Space required at Springwood *

Main Hall

Squash Courts

Dance Studio

Function Room

Number of courts required (max 4) *

Number of courts required (max 2) *

Number of rooms required (max 3) *

Day required *

Time required from and to *

Date required from *

Date required to *

Exclusion dates

Do you anticipate spectators?

Yes

No

Please state how many *

Do you require additional staff to help you with your booking? *

Yes

No

Payment options *

Monthly Direct Debit

Monthly invoice

Upload Direct Debit mandate *

Do you have a current Risk Assessment? *

Yes

No

Please upload your current Risk Assessment

Additional information (please provide any further information you feel relevant to your booking)

I agree to the terms and conditions *

Yes

I understand that if my payments are not made on time my booking will be suspended until outstanding invoices are cleared *

Yes

Send me Derby Parks information by email

Send me Derby Active information by email

Send me Derby Active information by post

Send me Derby Active information by phone/SMS

Apply for a Block Booking

Please complete the application below and we will be in contact to discuss your requirements.

Booking Information

Day and Time