St. Mary's Cathedral :: Agreement on the safe use of Cathedral premises

I/the organisation have obtained the written consent of the parents/carers responsible for all children and young people under the age of 18 with whom we will be working on these premises. *	Yes No
I/the organisation can confirm that we will exercise a supervisory function over any children and vulnerable adults that are present at our event(s), and we will endeavour to ensure that everyone is kept safe. *	Yes No
I/the organisation that I represent have/has a safeguarding policy in place and undertake(s) to follow the Code of Practice contained therein. A copy of the full policy has been provided to the person responsible for managing the premises. *	Yes No
I/the organisation that I represent do not have a safeguarding policy in place and undertake to comply fully with the Church's safeguarding policy and code of practice. *	Yes No
All those who are working with children, young people or vulnerable adults during this premises booking have gained membership of the PVG Scheme, where appropriate. *	Yes No
I understand that, if the organisation I represent is found to be in breach of this declaration, the Church reserves the right to cancel any booking agreement immediately. *	Yes
Name of hirer *
Email address *
Contact number *
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