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Athenaeum Centre - Theatrical Performance Hire Form
( Please either fill in online or print off and post )
   
Full Name of Hirer   Contact Name if differs from hirer:
   
   
Contact No
 Mobile No
 Email
   
   
Address of Hirer
   
 
   
The Athenaeum uses BACS payments - please enter your details below.
BACS Name
 BACS Acc No
 BACS Sort code
   
 
   
Title of Show
   
   
Brief Description
   

   
Target Age Range
Upto 8
 8-15
 16-21
 22-40
 40-65
 65+
   
   
Number of Shows
   Prices
 Interval ?
 Running Time
   
   
Please complete the following for each performance:
Date Get in Time Start Time Interval Time Interval Length End Time Get Out Time

 
We Would Like:
Licenced Bar Pre Show
Licenced Bar at Interval
Grand Piano
Electric Keyboard
 Tick Applicable:
Sending Signed Contract by Email
I have filled in my Contract Online
Sending Deposit by Bacs
Sending Public Liability Ins by Email
Sending Technical Requirements by Email
I have filled in my Technical Requirements Online
I understand the Child Protection Policy
I understand the Health & Safety Policy
 
Please specify any other requirements:

   
Type signature You accept this represents your signature.
Date: eg 31/03/2018
Address details for use only if you are printing the form and posting to:
Mrs Adela Forestier-Walker
The Athenaeum Centre
18 - 20 High Street, Warminster, BA12 9AE.
Email: [email protected]
07887 730199
( please set your print setup to portrait mode )

 or 

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