Space Hire Health & Safety Form

COCKPIT SPACE HIRE HEALTH & SAFETY FORM

First Name*

Last Name*

Contact Number

Email Address

Name hire is booked under (if different to the name given above)

Date hire is to take place*

If you are hiring a series of dates you only need to input the first one.

What space will you be using?*

You can make more than one selection if you will be using multiple spaces.

Studio 1

What activity will you be doing in the space?*

Feel free to keep it short and sweet here i.e. film shoot, acting rehearsal, read through...

How many people will be using the space (including you)?*

Any under 18?*

At the date and time of your hire will anyone using the space with you be under the age of 18?

Yes

Please confirm you have an up to date enhanced DBS certificate.*

You must have an up to date enhanced DBS if you'll be working with anyone under the age of 18. You will upload a copy in the final section of this form.

Please confirm you have conducted a risk assessment for your activity.*

It is your sole responsibility to ensure your risk assessment covers the scope and nature of your activity.

By ticking, you confirm that you have read, understood and agree to carry appropriate insurance for your activity.*

Are you teaching a class or offering some other service to others, paid or unpaid?

Then you need to carry professional and public liability insurance.

You will also need employers liability insurance if you are employing others to work with you, whether paid or unpaid.

Unsure about this? Just talk to the trade union or trade association most relevant to your field.

Dance teachers can check this link https://www.communitydance.org.uk/membership-and-insurance/insurance

By ticking this box you confirm that you have read, understood and agree to comply with our Health and Safety Housekeeping statement.*

We maintain our facilities in the best possible condition, but The Cockpit is an old building. Damage and imperfections are present and can occur suddenly during normal use. Sometimes, an activity that is normally safe may become compromised due to unexpected damage, such as to floor coverings or lighting.

It's your responsibility to undertake risk assessments for your activities and consider any limitations our facilities might present. We cannot monitor the building continuously so please check the space before use, alert us immediately to any issues, and if required, adjust or curtail your activities to account for the risk.

It's also important to read and comply with any signs in place for the safe use of facilities, whether permanent or temporary, and ensure that everyone working with you does the same.

Please note that none of our spaces are equipped with sprung floors and are therefore not suitable for pointe, tap, or other dance or physical theatre techniques that may cause microfractures or other injuries.

Assess the risks before you proceed!

File Upload

Upload copies of your dbs, insurance certificate here.

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