| EVENT DETAILS: |
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Name of Event |
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Date of Event |
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Type of Event |
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Start Time |
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Finish Time |
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No. People Expected |
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Do You Require a
Public Events Licence? |
Yes
No
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Who is the Licensing Body? |
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Location of Event |
Location |
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Street |
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Town |
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County |
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Postcode |
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Telephone |
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Location Map Supplied? |
Yes
No
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Event Contact Name |
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Event Contact Tel. |
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Nearest Hospital |
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Hospital Address |
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Hospital Telephone |
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Yes / No |
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Are Refreshments
Supplied for Staff? |
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Are Refreshments
Available on Site? |
/
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| TYPE OF COVER REQUIRED: |
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First Aider (FAW) |
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Ambulance Technician (EMT) |
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Paramedic (PAR) |
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Ambulance Technician + Ambulance |
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Paramedic + Ambulance |
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| BOOKING DETAILS: |
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To ensure that your event is covered appropriately and Health and Safety standards are maintained for both the public and our staff please ensure that you complete this form as fully as possible. It is important that you have read and understood the Alpha Care Independent Ambulance Services terms and conditions – if you have any queries relating to them please contact us directly.
I have read and agreed to the Alpha Care Ambulance Event Standard Terms and Conditions:
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Customer Information
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Purchase Order / Customer Reference
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Customer Email
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Company/Organisation
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Street 1
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Street 2
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Town/City
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County
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Postcode
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Please Note: Faxed and Online bookings must be confirmed verbally with Alpha Care Ambulance and are subject to the Event Standard Terms and Conditions. |
