Lead Teacher's Name

School Name

Description of Type of School (ie, Primary) :

Address Line 1

Address Line 2

Town / City

County

Postcode

School Telephone Number

School Email

Event Booked, e.g school visit:

Year Groups/Ages attending:

Preferred date of event

Start time of event

Teacher Mobile No for the day if the office is closed:

Where the event is to be held:

Description of activities

Total number of children attending:

Are other schools attending? Are other schools attending? Yes No

Is parking, adequate and near the entrance door for unloading heavy equipment: Is parking, adequate and near the entrance door for unloading heavy equipment: Yes No

Is the event room on the ground floor or are there lifts? Is the event room on the ground floor or are there lifts? Ground Floor Lifts Other

Second Contact if lead teacher absent on the day:

If we have asked for you to supply some resources, can you confirm these will be available on the day? If we have asked for you to supply some resources, can you confirm these will be available on the day? Yes No

If having the Planetarium is the floor clean and the ceiling the correct height? If having the Planetarium is the floor clean and the ceiling the correct height? Yes No

Relevant Health Information: Do we have any children attending with allergies, mobility issues etc.?

NB: We will require an hour to set-up and an hour to pack away. Is there anything else that you need to tell us?

Number