Worthing Town Centre Request to Leaflet

Name
First Last
Company Name
Address
Street Address Address Line 2 City ZIP / Postal Code
Email Address
Telephone Number
Mobile Number
Proposed Location for Leafleting
Proposed Date (s) for Leafleting
Brief description of what you propose to promote with your leafleting activity
Description of any equipment / costumes to be used while leafleting
Approximate number of people involved in the Event / Activity
Do you have public liability insurance?
- Yes
- No
Have you completed a risk assessment?
- Yes
- No
Consent*
By submitting this form, you are agreeing to the terms and conditions for holding events / activities in Worthing Town Centre.
Please send copies of Public Liability Insurance documentation and Risk Assessments (if required) to lindsay@worthingtowncentre.co.uk

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