Request first aid cover for your event

Region

Required North East East Midlands East of England London South East South West West Midlands North West

Event details

Event Title

Event Date

Time your event commences

When does your event finish

Time you would like us to start

When do you want our cover to finish

Event Address Line 1

Event Address Line 2

Event Town

Event County

Event Postcode

Related website

Tell us a bit more about your event. Please include any relevant details, such as if the event is ticketed, or if alcohol will be served.

Site contact name

Number of somebody we can contact at the event on the day

Event access/directions

Event insurance details

What insurance is in force?

What is the limit of indemnity?

Who will be attending this event?

Will there be general public on site?

-- Select an option -- Yes No

What is the maximum number of people expected at any one time

Make up of crowd

Select make up of crowd Full mix, in family groups Full mix, not in family groups Predominantly young adults Predominantly children & teenagers Predominantly elderly Full mix, rival factions

Event Facilities available to St John Ambulance

Will free refreshments be provided?

-- Select an option -- Yes No

Access to toilet facilities?

-- Select an option -- Yes No

Drinking water available

-- Select an option -- Yes No

Parking available?

-- Select an option -- Yes No

Emergency exit available?

-- Select an option -- Yes No

Does your event license require you to have a doctor present?

-- Select an option -- Yes No

Name of nearest hospital

Are there any other on-site facilities, for example, a first aid room?

Please provide details of any other organisation(s) involved in the medical/ first aid provision for this event:

Will any of the following activities take place at this event?

Street carnival

Yes

Street theatre

Yes

Fireworks

Yes

Climbing

Yes

Abseiling

Yes

Motorised Water Sports

Yes

Helicopters

Yes

Model flying display

Yes

Parachute display

Yes

Contact sport

Yes

Quad bikes

Yes

Other motor sports

Yes

Your details (person making booking)

Company Name

Customer Address Line 1

Customer Address Line 2

Customer Town

Customer County

Customer Postcode

Contact Name

Customer Email Address

Customer Daytime Phone

Customer Evening Phone

Billing details

Account Name/Number

Order no/ref no

Invoice Address Line 1

Invoice Address Line 2

Town

County

Invoice address postcode

Finance Contact Name

Finance contact email address

Finance contact daytime telephone

Finance contact evening telephone

Submit