Youth Space Re-booking Form
PN Youth Space
Street Address: 1-7 Coleman Place, Palmerston North
Phone 06 351 4126 Email:
Facebook: - @pnyouthspace
Before completing this form, please read the “Booking Conditions for Use of Premises”
Email address *
Contact Details
Contact Name
Your answer
Phone Number
Your answer
Your answer
Have you/organisation booked the Youth Space in the past? *
Name of your event/booking?
Your answer
Purpose of the event/activity?
Your answer
This Booking is:
Number of people expected to attend your event?
Your answer
Facilities Required
If your event/booking a one off?
Booking Date/Day
Your answer
Time - Please include your set up time and clean up times in your booking.
Your answer
Booking Agreement - Terms & Conditions
I, _______________________________________________ (name)
Your answer
am the nominated representative of ___________________________(Organisation Name) and
Your answer
I hold the position of _________________________________________(Position Name)
Your answer
Booking Agreement - Terms & Conditions *
Signature of Applicant (Print Name)
Your answer
Todays Date of Signature Agreement
A copy of your responses will be emailed to the address you provided.
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