Football Block Booking Application

Name *

Team Name

Address *

Home phone number

Mobile phone number *

Email address *

Confirm Email address *

Are the hirer details the same as above? *

Yes

No

Hirer name *

Hirer address *

Hirer home phone number

Hirer mobile number *

Hirer email address *

Confirm Hirer email address *

Activity to be undertaken *

Venue required *

Springwood Leisure Centre (open Mon - Fri 9am - 10pm, Sat 9am - 7pm, Sun 9am - 9pm)

Moorways Stadium (7 a side and sand based surface open Mon - Fri 5pm - 9pm, Sat 9am - 4pm, Sun 9am - 4pm)

Racecourse (Monday – Friday 5-9pm Saturday-Sunday 10-4pm)

Number of pitches

1 pitch

2 pitches

Size of pitch *

1/3rd

2/3rds

Full pitch

I can be flexible on my venue

Yes

Day required *

Time required to and from (on the hour only available at Springwood) *

Start date for booking *

End date of booking

Exclusion dates

Adult or Junior

Adult

Junior

Do you anticipate spectators? *

Yes

No

Please state how many spectators you anticipate *

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

Yes

No

Payment options (Springwood and Moorways) *

Monthly direct debit

Cash/card

Payment options (Racecourse) *

Monthly direct debit

One off up-front payment by cash or card for the whole booking period

Three or four cash or card payments during the booking period depending on the length of your booking – (May, July, Oct and Jan)

Do you require an invoice? *

Yes

No

Do you have a Charter Standard Mark?

Yes

No

Please upload Charter evidence here *

Do you wish to apply for VAT exemption on your booking?

Yes

No

Are you one of the following *

School

An association or organisation representing affiliated clubs or constituent associations, such as a local league

A club

Please upload evidence here *

Additional information (please provide any further information you feel is 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

Football Block Booking Application

Is your club, sports team or group of friends looking for a astroturf pitch to hire for a regular booking?

Contact details

Booking information