Nights Away Permit Application
If you wish to gain a permit to lead Nights Away events with Hallam District, please fill in this form. When you press the submit button it will be sent to the Hallam District Nights Away Assessor Team - Please check that you see the confirmation window.
Personal Details
Full Name *
Please include the name by which you are known e.g Pete rather than Peter.
Your answer
Current Group *
Please indicate which Group you are helping with in Hallam District
Current Section *
Date Of Birth *
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E-Mail Address *
Please check this for accuracy as this will be used to contact you.
Your answer
Home Address *
Your answer
Contact Phone Number
Please split code from number e.g. 0114 123456 or 07123 456789
Your answer
Health Factors
Things that may affect running Nights Away events
Your answer
Permit Type
Permit Applied For *
Experience Details
Please list any relevant training courses attended and nights away events that you have been involved in running or organising.
MOST RECENT FIRST (If you have more than 10 events to tell us about please include very brief details in the NOTES box at the end of this form - similarly please don't feel you have to complete all 10 spaces)
DATES: Where known enter the start date of the event. However if you can't remember exact dates use 1st of the Month.
Event 1
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Brief Details (Event 1)
Your answer
Event 2
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Brief Details (Event 2)
Your answer
Event 3
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Brief Details (Event 3)
Your answer
Event 4
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Brief Details (Event 4)
Your answer
Event 5
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Brief Details (Event 5)
Your answer
Event 6
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YYYY
Brief Details (Event 6)
Your answer
Event 7
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Brief Details (Event 7)
Your answer
Event 8
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Brief Details (Event 8)
Your answer
Event 9
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Brief Details (Event 9)
Your answer
Event 10
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Brief Details (Event 10)
Your answer
Notes
Any other Info
Your answer
SUBMIT
Please check that you have included required information indicated with a red * above and then press the Submit button below.
If successful you will see a confirmation - if you don't please check that you have completed all the required questions.
Submit
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